Individual provider Active NPI

Miriam Morales Ocillos, P.T.

  • Physical Therapist
  • Rockford, IL
National Provider Identifier
1356483952
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.014789 Issued in IL
Practice address
1301 N Alpine Rd # 201
Rockford, IL 61107-2262
Phone
(779) 696-0700
Fax
(779) 696-0710
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 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 070.014789 IL Primary

Addresses

Primary practice location

1301 N Alpine Rd # 201
Rockford, IL 61107-2262

Mailing address

1401 E State St
Rockford, IL 61104-2315
Phone (815) 968-4400

Other practice location 1

1401 E State St
Rockford, IL 61104-2315
Phone (815) 968-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000444 IL Practitioner - Physical Therapist in Private Practice 8123107869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1301 N Alpine Rd
Suite 201
Rockford, IL 61107-2262
Phone (779) 696-0700

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.014789ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Apr 9, 2024 Accepting new patients
Swedishamerican Hospital CurrentSince Apr 9, 2024 Accepting new patients
Swedishamerican Hospital Physical Therapist CurrentSince Apr 21, 2024 Accepting new patients

Locations

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

1301 N Alpine Rd
#201
Rockford, IL 61107
Phone (779) 696-0700

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

1301 N Alpine Rd
Ste 201
Rockford, IL 61107
Phone (779) 696-0700

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1356483952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "815-968-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N ALPINE RD # 201",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072262",
            "telephone_number": "779-696-0700",
            "fax_number": "779-696-0710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 E State St",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611042315",
            "country_code": "US",
            "telephone_number": "815-968-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCILLOS",
        "first_name": "MIRIAM",
        "middle_name": "MORALES",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.