Individual provider Active NPI

Bree Ann McClusky Ocasio, DPT, PT

  • Physical Therapist
  • Champaign, IL
National Provider Identifier
1326231200
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
70015763 Issued in IL
Practice address
2110 Fox Dr Ste B
Champaign, IL 61820-7596
Phone
(217) 366-1323
NPI assigned
Aug 23, 2007
Last updated
Jul 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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 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

IdentifierTypeStateIssuer
7216OtherILPERSONALCARE PROVIDER ID
113326OtherILHEALTHLINK
203OtherILBLUE CROSS PROVIDER ID
4117OtherILHAMP PROVIDER ID

Other names 1

  • Bree Ann McClusky Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809000263 IL Practitioner - Physical Therapist in Private Practice 1658665088 Reassigns benefits to 1 organization

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
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

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

LicenseStateTypeSpecialty
70015763ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Clinic, PLLC Physical Therapist CurrentSince Jun 13, 2016 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.

Verify at the official NPI Registry.