Individual provider Active NPI

Scott Johnson, PT, MPT, OCS

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1235270570
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013698 Issued in IL
Practice address
25 E Washington St
Suite 1310
Chicago, IL 60602-1708
Phone
(312) 259-5712
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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 070013698 IL Primary

Addresses

Primary practice location

25 E Washington St
Suite 1310
Chicago, IL 60602-1708

Mailing address

4111 N Oakley Ave
Chicago, IL 60618-2925
Phone (312) 259-5712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000075 IL Practitioner - Physical Therapist in Private Practice 5294729513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Ohio Medical University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25 E Washington St
Suite 1735
Chicago, IL 60602-1882
Phone (312) 259-5712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070013698ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pegasus Physical Therapy LLC CurrentSince Nov 1, 2014 Accepting new patients
Accelerated Rehabilitation Centers LTD Physical Therapist Past Accepting new patients

Locations

25 E Washington St
Ste 1310
Chicago, IL 60602
Phone (312) 855-1711

25 E Washington St
Ste 1735
Chicago, IL 60602
Phone (312) 259-5712

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1235270570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182925",
            "telephone_number": "312-259-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 1310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-259-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCOTT",
        "credential": "PT, MPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.