Organization Active NPI

Optimum Physical Therapy, Inc.

  • Physical Therapist
  • Des Plaines, IL
National Provider Identifier
1205842986
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070012356 Issued in IL
Legal business name
OPTIMUM PHYSICAL THERAPY, INC.
Practice address
9301 Golf Rd
Ste 204
Des Plaines, IL 60016-1667
Phone
(847) 391-9720
Fax
(847) 391-9721
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Snehal Mehta, PTNPI 1578537965
Title
Owner
Phone
(847) 391-9720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 070012356 IL Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 070011869 IL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 056006131 IL

Addresses

Primary practice location

9301 Golf Rd
Ste 204
Des Plaines, IL 60016-1667

Mailing address

9301 Golf Rd
Ste 204
Des Plaines, IL 60016-1667
Phone (847) 391-9720

Other identifiers 2

IdentifierTypeStateIssuer
352728176001MedicaidIL
01635425OtherILBC/BS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050927000331 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8820022098 Receives reassigned benefits from 2 practitioners
Practice locations: Des Plaines, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1205842986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 GOLF RD",
            "address_2": "STE 204",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161667",
            "telephone_number": "847-391-9720",
            "fax_number": "847-391-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 GOLF RD",
            "address_2": "STE 204",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161667",
            "telephone_number": "847-391-9720",
            "fax_number": "847-391-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "SNEHAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-391-9720",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070012356",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011869",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056006131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352728176001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "01635425",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.