NPIMap

Individual provider Active NPI

Pritesh J Patel, OTR

  • Occupational Therapist
  • Park Ridge, IL
National Provider Identifier
1366598419
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.006288 Issued in IL
Practice address
1600 Dempster St
Suite 102
Park Ridge, IL 60068-1109
Phone
(847) 296-9040
Fax
(847) 296-9050
NPI assigned
Jan 25, 2007
Last updated
Feb 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.006288 IL Primary

Addresses

Primary practice location

1600 Dempster St
Suite 102
Park Ridge, IL 60068-1109

Mailing address

1600 Dempster St
Suite 102
Park Ridge, IL 60068-1109
Phone (847) 296-9040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060125000148 IL Practitioner - Occupational Therapist in Private Practice 8729002225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.006288ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxe Hospice and Palliative Care LLC PastSince Mar 10, 2023 Accepting new patients
Crystal Lab Works LLC PastSince Nov 1, 2021 Accepting new patients
LMR Indiana Home Health Inc PastSince Jan 1, 2025 Accepting new patients
Premier Rehab Services LLC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Luxe Home Health LLCMerrillville, IN, CCN 157592 Home health agency 5% Or Greater Indirect Ownership Interest (50%)
Corporate Officer		 Jan 1, 2025
Jan 1, 2025
Whole Life Home Health, LLCDes Plaines, IL, CCN 148317 Home health agency Corporate Officer (33%)
Corporate Director (33%)
W-2 Managing Employee (33%)
Operational/Managerial Control (33%)		 Apr 30, 2015
Apr 30, 2015
Apr 30, 2015
Apr 30, 2015
Luxe Home Health LLCKansas City, MO, CCN 267682 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Director (25%)
W-2 Managing Employee (25%)		 Apr 4, 2023
Apr 4, 2023
Apr 4, 2023
Luxe Hospice and Palliative Care LLCDes Plaines, IL, CCN 141740 Hospice Operational/Managerial Control (50%) Mar 10, 2023

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1366598419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DEMPSTER ST",
            "address_2": "SUITE 102",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681109",
            "telephone_number": "847-296-9040",
            "fax_number": "847-296-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DEMPSTER ST",
            "address_2": "SUITE 102",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681109",
            "telephone_number": "847-296-9040",
            "fax_number": "847-296-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRITESH",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.006288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.