Individual provider Active NPI

Gazanfer Mushtaq, PT

  • Physical Therapist
  • Addison, IL
National Provider Identifier
1245621325
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070021234 Issued in IL
Practice address
1776 W Centennial PL
Addison, IL 60101-1075
Phone
(630) 953-0343
Fax
(630) 953-0353
NPI assigned
Feb 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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 070021234 IL Primary

Addresses

Primary practice location

1776 W Centennial PL
Addison, IL 60101-1075

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200

Other practice location 1

7653 Weymouth Cir
Hanover Park, IL 60133-2755
Phone (734) 354-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190501000900 IL Practitioner - Physical Therapist in Private Practice 8628310216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1776 W Centennial PL FL
Suite 2
Addison, IL 60101-1075
Phone (630) 953-0343

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070021234ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Apr 19, 2019 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Apr 19, 2019 Accepting new patients

Locations

1776 W Centennial Pl
Fl 2
Addison, IL 60101
Phone (630) 953-0343

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

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": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1245621325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 W CENTENNIAL PL",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011075",
            "telephone_number": "630-953-0343",
            "fax_number": "630-953-0353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7653 Weymouth Cir",
            "address_purpose": "LOCATION",
            "city": "Hanover Park",
            "state": "IL",
            "postal_code": "601332755",
            "country_code": "US",
            "telephone_number": "734-354-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSHTAQ",
        "first_name": "GAZANFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-11",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.