Individual provider Active NPI

Joshua D Vandorin, PT, DPT

  • Physical Therapist
  • West Dundee, IL
National Provider Identifier
1326442989
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.020822 Issued in IL
Practice address
621 S 8TH St
West Dundee, IL 60118-2106
Phone
(800) 974-4378
Fax
(630) 515-1536
NPI assigned
Oct 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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 070.020822 IL Primary

Addresses

Primary practice location

621 S 8TH St
West Dundee, IL 60118-2106

Mailing address

24014 W Renwick Rd Unit 206
Plainfield, IL 60544-8711
Phone (800) 974-4378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141103001616 IL Practitioner - Physical Therapist in Private Practice 1052533254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
DPT Holdings PLLC Physical Therapist CurrentSince May 18, 2023 Accepting new patients
DPT Holdings PLLC PastSince Apr 30, 2023 Accepting new patients
Moffett Physical Therapy, Inc. PastSince Jun 13, 2014 Accepting new patients

Locations

24014 W Renwick Rd
Ste 206
Plainfield, IL 60544

621 S 8th St
West Dundee, IL 60118

Organizations & group practices 3

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1326442989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD UNIT 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S 8TH ST",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601182106",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDORIN",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.