Individual provider Active NPI

Dara Claire Dantzler, DPT

  • Physical Therapist
  • Great Neck, NY
National Provider Identifier
1386137610
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
90 E Shore Rd
Great Neck, NY 11023-2409
Phone
(516) 684-1122
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 Primary

Addresses

Primary practice location

90 E Shore Rd
Great Neck, NY 11023-2409

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Dara Johnson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115001535 SC Practitioner - Physical Therapist in Private Practice 3971852823 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
RSFH - Ati Physical Therapy LLCGroup PAC ID 3375849946, 98 clinicians

Practice addresses (Care Compare)

606 Nexton Square Dr
Suite 304
Summerville, SC 29486-7914
Phone (843) 376-5963

Merit-based Incentive Payment System (MIPS)

Final score
86.49 of 100Reported as group
Quality
89.43
Improvement activities
40
Cost
74.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11422SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33299 Collection Ctr Dr
Chicago, IL 60693

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

606 Nexton Square Dr
Ste 304
Summerville, SC 29486
Phone (843) 376-5963

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1386137610",
    "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": "90 E SHORE RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232409",
            "telephone_number": "516-684-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "DARA",
        "middle_name": "CLAIRE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARA",
            "last_name": "JOHNSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.