Individual provider Active NPI

Mayra Pluta, PTA

  • Physical Therapy Assistant
  • Romeoville, IL
National Provider Identifier
1235262213
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160002963 Issued in IL
Practice address
605 S Edward Dr
Romeoville, IL 60446-6507
Phone
(630) 863-7772
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160002963 IL Primary

Addresses

Primary practice location

605 S Edward Dr
Romeoville, IL 60446-6507

Mailing address

605 Edward Dr
Romeoville, IL 60446-6507
Phone (630) 863-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160002963ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1235262213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 EDWARD DR",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604466507",
            "telephone_number": "630-863-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S EDWARD DR",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604466507",
            "telephone_number": "630-863-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUTA",
        "first_name": "MAYRA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeoville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.