Individual provider Active NPI

Anelise Wink, PT

  • Physical Therapist
  • Houston, TX
National Provider Identifier
1194770982
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1170613 Issued in TX
Practice address
6624 Fannin St
Suite 2600
Houston, TX 77030-2312
Phone
(713) 790-1818
Fax
(713) 790-7500
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-014104 IL
Physical Therapist 225100000X 1170613 TX Primary

Addresses

Primary practice location

6624 Fannin St
Suite 2600
Houston, TX 77030-2312

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other identifiers 1

IdentifierTypeStateIssuer
741660214OtherTXTAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000195 TX Practitioner - Physical Therapist in Private Practice 9436172095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

861 N Tarrant Pkwy
Unit 100
Keller, TX 76248-6601
Phone (817) 918-2480

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-014104ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Aug 21, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 21, 2023 Accepting new patients
Illinois Bone and Joint Institute Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

1401 William D Tate Ave
Ste 300
Grapevine, TX 76051
Phone (817) 527-3377

861 North Tarrant Pkwy
Unit 100
Keller, TX 76248
Phone (817) 918-2480

245 W State Highway 114
Ste 320
Southlake, TX 76092
Phone (817) 873-5311

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1194770982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FANNIN ST",
            "address_2": "SUITE 2600",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302312",
            "telephone_number": "713-790-1818",
            "fax_number": "713-790-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINK",
        "first_name": "ANELISE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-014104",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1170613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "741660214",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.