Individual provider Active NPI

Andrea M Piasecki, PT

  • Physical Therapist
  • Moline, IL
National Provider Identifier
1366540395
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070013907 Issued in IL
Practice address
5111 22ND Ave
Moline, IL 61265-3681
Phone
(309) 762-7979
Fax
(309) 762-7979
NPI assigned
Sep 21, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 070013907 IL Primary

Addresses

Primary practice location

5111 22ND Ave
Moline, IL 61265-3681

Mailing address

5111 22ND Ave
Moline, IL 61265-3681
Phone (309) 762-7979

Other identifiers 1

IdentifierTypeStateIssuer
070-013907OtherILILLINOIS PT LICENSE NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist PastSince Sep 26, 2008 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist Past Accepting new patients

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, 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1366540395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 22ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653681",
            "telephone_number": "309-762-7979",
            "fax_number": "309-762-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 22ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653681",
            "telephone_number": "309-762-7979",
            "fax_number": "309-762-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIASECKI",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PT LICENSE NUMBE",
            "identifier": "070-013907",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.