Individual provider Active NPI

John Robert Moynihan, DPT

  • Physical Therapist
  • Palatine, IL
National Provider Identifier
1295419497
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.028378 Issued in IL
Practice address
315 E Northwest Hwy
Palatine, IL 60067-8116
Phone
(847) 701-1930
Fax
(847) 701-1931
NPI assigned
Jun 9, 2023
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.028378 IL Primary
Physical Therapist 225100000X 16291-24 WI

Addresses

Primary practice location

315 E Northwest Hwy
Palatine, IL 60067-8116

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258

Other practice location 1

621 Science Dr
Madison, WI 53711-1074
Phone (608) 265-8303

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240717002442 IL Practitioner - Physical Therapist in Private Practice 0941745673 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
Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

315 E Northwest Hwy
Palatine, IL 60067-8116
Phone (847) 701-1930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.028378ILMDPhysical Therapist
16291-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3973 W Algonquin Rd
Algonquin, IL 60102
Phone (224) 348-7600

10801 S Western Ave
Chicago, IL 60643
Phone (773) 445-4200

315 E Northwest Hwy
Palatine, IL 60067
Phone (847) 701-1930

9 N 2nd St
St Charles, IL 60174
Phone (630) 526-4200

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1295419497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678116",
            "telephone_number": "847-701-1930",
            "fax_number": "847-701-1931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 Science Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537111074",
            "country_code": "US",
            "telephone_number": "608-265-8303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028378",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16291-24",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.