Individual provider Active NPI

Paul Vincent Ilagan Tolentino

  • Occupational Therapist
  • South Barrington, IL
National Provider Identifier
1215248752
Registry record updated Feb 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056010294 Issued in IL
Practice address
5 Willowmere Dr
South Barrington, IL 60010-6151
Phone
(646) 417-3354
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056010294 IL Primary

Addresses

Primary practice location

5 Willowmere Dr
South Barrington, IL 60010-6151

Mailing address

5 Willowmere Dr
South Barrington, IL 60010-6151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220316003874 IL Practitioner - Occupational Therapist in Private Practice 5991190548 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424476800000",
    "number": "1215248752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WILLOWMERE DR",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600106151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WILLOWMERE DR",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600106151",
            "telephone_number": "646-417-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "PAUL VINCENT",
        "middle_name": "ILAGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2015-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056010294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2015; 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.