Individual provider Active NPI

Bryan D Ryndak, PT,MHS

  • Geriatric Physical Therapist
  • Woodstock, IL
National Provider Identifier
1205051901
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
070-007745 Issued in IL
Practice address
521 Blue Bonnet LN
Woodstock, IL 60098-4181
Phone
(224) 828-9310
NPI assigned
Apr 16, 2007
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-007745 IL
Geriatric Physical Therapist 2251G0304X 070-007745 IL Primary
Sports Physical Therapist 2251S0007X 070-007745 IL
Orthopedic Physical Therapist 2251X0800X 070-007745 IL

Addresses

Primary practice location

521 Blue Bonnet LN
Woodstock, IL 60098-4181

Mailing address

521 Blue Bonnet LN
Woodstock, IL 60098-4181
Phone (224) 828-9310

Other practice location 1

732 Northwest Hwy
Cary, IL 60013
Phone (847) 462-0780

Other practice location 2

732 Northwest Hwy
Cary, IL 60013
Phone (847) 462-0780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070829000115 IL Practitioner - Physical Therapist in Private Practice 7113019696 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-007745ILMDOrthopedic Physical Therapist

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1205051901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 BLUE BONNET LN",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600984181",
            "telephone_number": "224-828-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 BLUE BONNET LN",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600984181",
            "telephone_number": "224-828-9310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "IL",
            "postal_code": "60013",
            "country_code": "US",
            "telephone_number": "847-462-0780",
            "fax_number": "847-462-0755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "732 Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "IL",
            "postal_code": "60013",
            "country_code": "US",
            "telephone_number": "847-462-0780",
            "fax_number": "847-462-0755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYNDAK",
        "first_name": "BRYAN",
        "middle_name": "D",
        "credential": "PT,MHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-007745",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IL",
            "license": "070-007745",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "IL",
            "license": "070-007745",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070-007745",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.