Individual provider Active NPI

Jessica Perez, PT

  • Physical Therapist
  • Trophy Club, TX
National Provider Identifier
1366926875
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1310029 Issued in TX
Practice address
2800 E Highway 114 Ste 120
Trophy Club, TX 76262-5305
Phone
(174) 913-4038
Fax
(817) 491-3308
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 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 1310029 TX Primary

Addresses

Primary practice location

2800 E Highway 114 Ste 120
Trophy Club, TX 76262-5305

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

4420 Dickason Ave Apt 1340
Dallas, TX 75219-6645
Phone (417) 872-6501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181109000930 TX Practitioner - Physical Therapist in Private Practice 6406100486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 W FM
544 Suite 105
Murphy, TX 75094-3715
Phone (469) 606-5003

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1310029TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Nov 9, 2020 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Nov 9, 2020 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

106 N Denton Tap Rd
Ste 220
Coppell, TX 75019
Phone (469) 528-6437

9291 Garland Rd
Ste 110
Dallas, TX 75218
Phone (972) 892-4541

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

9660 Audelia Rd
Ste 101
Dallas, TX 75238
Phone (214) 273-0510

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

6333 E Mockingbird Ln
Ste 139
Dallas, TX 75214
Phone (469) 782-7786

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

6828 Stonebrook Pkwy
Ste 300
Frisco, TX 75034
Phone (469) 403-2022

5129 N Garland Ave
Ste 600
Garland, TX 75040
Phone (469) 838-4072

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

491 S Angel Pkwy
Ste 400
Lucas, TX 75002
Phone (972) 737-6161

410 W FM 544
Ste 105
Murphy, TX 75094
Phone (469) 606-5003

4709 W Parker Rd
Ste 460
Plano, TX 75093
Phone (469) 440-5420

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

1450 E Belt Line Rd
Ste 200
Richardson, TX 75081
Phone (214) 210-4409

2268 N Lake Shore Dr
Ste 106
Rockwall, TX 75087
Phone (214) 771-7960

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

809 Woodbridge Pkwy
Ste 200
Wylie, TX 75098
Phone (469) 299-5803

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1366926875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E HIGHWAY 114 STE 120",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625305",
            "telephone_number": "174-913-4038",
            "fax_number": "817-491-3308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Dickason Ave Apt 1340",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752196645",
            "country_code": "US",
            "telephone_number": "417-872-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JESSICA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1310029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

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