Active NPI
Bree Ann McClusky Ocasio, DPT, PT
- Physical Therapist
- Champaign, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 70015763
- Practice address
- 2110 Fox Dr Ste B
Champaign, IL 61820-7596 - Phone
- (217) 366-1323
- NPI assigned
- Aug 23, 2007
- Last updated
- Jul 13, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 70015763 | IL | Primary |
Addresses
Primary practice location
2110 Fox Dr Ste B
Champaign, IL 61820-7596
Mailing address
2110 Fox Dr Ste B
Champaign, IL 61820-7596
Phone (217) 366-1323
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7216 | Other | IL | PERSONALCARE PROVIDER ID |
| 113326 | Other | IL | HEALTHLINK |
| 203 | Other | IL | BLUE CROSS PROVIDER ID |
| 4117 | Other | IL | HAMP PROVIDER ID |
Other names 1
- Bree Ann McClusky
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70015763 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christie Clinic, PLLC | Physical Therapist | Current | Accepting new patients |
Locations
101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255
2110 Fox Dr
Ste B
Champaign, IL 61820
Phone (217) 355-1616
3101 Fields South Dr
Champaign, IL 61822
Phone (217) 366-1237
1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684
Organizations & group practices 1
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": "1187827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468368000000",
"number": "1326231200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 FOX DR STE B",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207596",
"telephone_number": "217-366-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 FOX DR STE B",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207596",
"telephone_number": "217-366-1323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLUSKY OCASIO",
"first_name": "BREE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-23",
"last_updated": "2016-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "70015763",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONALCARE PROVIDER ID",
"identifier": "7216",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "113326",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "203",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAMP PROVIDER ID",
"identifier": "4117",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BREE",
"last_name": "MCCLUSKY",
"middle_name": "ANN",
"credential": "PT, DPT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.