Individual provider Active NPI

Sheina Burillo Norgaard, PT

  • Physical Therapist
  • Highland, IL
National Provider Identifier
1215165097
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070017134 Issued in IL
Practice address
100 Augusta Dr
Highland, IL 62249-2884
Phone
(646) 943-3135
Fax
(618) 488-6433
NPI assigned
Jun 30, 2009
Last updated
Apr 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070017134 IL Primary

Addresses

Primary practice location

100 Augusta Dr
Highland, IL 62249-2884

Mailing address

100 Augusta Dr
Highland, IL 62249-2884
Phone (646) 943-3135

Other identifiers 2

IdentifierTypeStateIssuer
204-049-068OtherILUSCIS
UU0095314OtherPASSPORT

Other names 1

  • Sheina Burillo Piencenaves Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220610001479 IL Practitioner - Physical Therapist in Private Practice 8628456126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince May 31, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince May 31, 2022 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1215165097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AUGUSTA DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492884",
            "telephone_number": "646-943-3135",
            "fax_number": "618-488-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 AUGUSTA DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492884",
            "telephone_number": "646-943-3135",
            "fax_number": "618-488-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORGAARD",
        "first_name": "SHEINA",
        "middle_name": "BURILLO",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USCIS",
            "identifier": "204-049-068",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "UU0095314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEINA",
            "last_name": "PIENCENAVES",
            "middle_name": "BURILLO",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.