Individual provider Active NPI

Joseph Stewart, PT, DPT, CSCS

  • Physical Therapist
  • Grapevine, TX
National Provider Identifier
1265117295
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1377319 Issued in TX
Practice address
2030 Glade Rd Ste 200
Grapevine, TX 76051-7360
Phone
(817) 684-0397
Fax
(817) 684-8253
NPI assigned
Jun 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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 1377319 TX Primary

Addresses

Primary practice location

2030 Glade Rd Ste 200
Grapevine, TX 76051-7360

Mailing address

PO Box 2650
Coppell, TX 75019-8607
Phone (972) 724-2400

Other practice location 1

2629 N Stemmons Fwy Ste 225
Dallas, TX 75207-2115
Phone (469) 248-6960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230906001043 TX Practitioner - Physical Therapist in Private Practice 5193188365 Reassigns benefits to 1 organization
I20260519003080 IL Practitioner - Physical Therapist in Private Practice 5193188365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freeform Physical Therapy LLCGroup PAC ID 0941622815, 7 clinicians

Practice addresses (Care Compare)

2906 W Fullerton Ave
Chicago, IL 60647-2921
Phone (773) 698-6659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Freeform Physical Therapy LLC Physical Therapist CurrentSince Apr 20, 2026 Accepting new patients
Elite Alliance Physical Therapy PLLC Physical Therapist CurrentSince Jun 19, 2023 Accepting new patients

Locations

2070 N Clybourn Ave
Unit F
Chicago, IL 60614
Phone (773) 904-7158

2906 W Fullerton Ave
Chicago, IL 60647
Phone (773) 301-3735

2629 N Stemmons Fwy
Ste 225
Dallas, TX 75207
Phone (469) 248-6960

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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1265117295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750198607",
            "telephone_number": "972-724-2400",
            "fax_number": "972-724-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 GLADE RD STE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517360",
            "telephone_number": "817-684-0397",
            "fax_number": "817-684-8253"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2629 N Stemmons Fwy Ste 225",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752072115",
            "country_code": "US",
            "telephone_number": "469-248-6960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JOSEPH",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1377319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.