Individual provider Active NPI

Angela Vizcaino, DPT

  • Physical Therapist
  • Fort Worth, TX
National Provider Identifier
1306670864
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1400039 Issued in TX
Practice address
12345 Alta Vista Rd Ste 113
Fort Worth, TX 76244-6436
Phone
(682) 593-2550
NPI assigned
Aug 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 1400039 TX Primary

Addresses

Primary practice location

12345 Alta Vista Rd Ste 113
Fort Worth, TX 76244-6436

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (803) 812-3656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925000654 TX Practitioner - Physical Therapist in Private Practice 2860933280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
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)

12345 Alta Vista Rd
Suite 113
Fort Worth, TX 76244-6436
Phone (682) 593-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Sep 4, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Sep 4, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

5510 Abrams Rd
Ste 115
Dallas, TX 75214
Phone (214) 265-9700

12345 Alta Vista Rd
Ste 113
Fort Worth, TX 76244
Phone (682) 593-2550

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

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": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1306670864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "803-812-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12345 ALTA VISTA RD STE 113",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446436",
            "telephone_number": "682-593-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZCAINO",
        "first_name": "ANGELA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1400039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.