Individual provider Active NPI

Ian M McKelvey, PT

  • Physical Therapist
  • Puyallup, WA
National Provider Identifier
1396096087
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 60532240 Issued in WA
Practice address
3912 10TH St SE
Ste 101
Puyallup, WA 98374-2188
Phone
(253) 848-4700
Fax
(253) 848-2284
NPI assigned
Sep 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT022469 PA
Physical Therapist 225100000X PT 60532240 WA Primary

Addresses

Primary practice location

3912 10TH St SE
Ste 101
Puyallup, WA 98374-2188

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130520000025 PA Practitioner - Physical Therapist in Private Practice 9931346574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

73 Old Dublin Pike
Suite 6
Doylestown, PA 18901-2491
Phone (215) 489-1701

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT022469PAMDPhysical Therapist
PT 60532240WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 30, 2019 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 30, 2019 Accepting new patients
Ati Holdings, LLC Past Accepting new patients
Ati Holdings, LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

44 W Skippack Pike
Ambler, PA 19002
Phone (267) 419-2020

101 W City Ave
Ste B
Bala Cynwyd, PA 19004
Phone (484) 270-9170

2641 Street Rd
Bensalem, PA 19020
Phone (267) 525-0135

220 Commerce Cir
Bristol, PA 19007
Phone (215) 826-8089

28 E Ridge Pike
#A3
Conshohocken, PA 19428
Phone (484) 533-2692

73 Old Dublin Pike
Ste 6
Doylestown, PA 18901
Phone (215) 348-0666

634 Old York Rd
Jenkintown, PA 19046
Phone (215) 881-9181

2022 E Old Lincoln Hwy
Ste 6
Langhorne, PA 19047
Phone (215) 891-5150

776 Bethlehem Pike
#2
Montgomeryville, PA 18936
Phone (267) 328-1310

770 Newtown Yardley Rd
Newtown, PA 18940
Phone (215) 860-2990

626 Market St
Philadelphia, PA 19106

1100 S Christopher Columbus Blvd
Ste 25
Philadelphia, PA 19147
Phone (267) 592-4508

7164 Ridge Ave
Ste 17A
Philadelphia, PA 19128
Phone (267) 748-2430

180 W Girard Ave
Ste 1
Philadelphia, PA 19123
Phone (267) 592-4033

2121 Cottman Ave
#14
Philadelphia, PA 19149
Phone (267) 668-1891

9475 Roosevelt Blvd
Philadelphia, PA 19114
Phone (215) 464-6200

9475 Roosevelt Blvd
#B4
Philadelphia, PA 19114
Phone (215) 464-6200

682 N West End Blvd
Ste B
Quakertown, PA 18951

118 Townsedge Dr
Quarryville, PA 17566
Phone (717) 806-5126

1810 E Ridge Pike
Ste 102
Royersford, PA 19468
Phone (484) 902-1460

300 Upland Sq Dr
Stowe, PA 19464
Phone (610) 340-1527

630 Easton Rd
Warrington, PA 18976
Phone (215) 491-5961

Organizations & group practices 4

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": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1396096087",
    "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",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 10TH ST SE",
            "address_2": "STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-4700",
            "fax_number": "253-848-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKELVEY",
        "first_name": "IAN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT022469",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60532240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.