Individual provider Active NPI

Raymond Vincent Pineda

  • Physical Therapist
  • Bensenville, IL
National Provider Identifier
1396211561
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023801 Issued in IL
Practice address
111 E Washington St
Bensenville, IL 60106-2674
Phone
(630) 766-5800
NPI assigned
Oct 15, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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 070023801 IL Primary

Addresses

Primary practice location

111 E Washington St
Bensenville, IL 60106-2674

Mailing address

111 E Washington St
Bensenville, IL 60106-2674

Other practice location 1

2536 Linda Ct
Glenview, IL 60025-4724
Phone (224) 522-7109

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070023801ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1396211561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WASHINGTON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WASHINGTON ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062674",
            "telephone_number": "630-766-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2536 Linda Ct",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600254724",
            "country_code": "US",
            "telephone_number": "224-522-7109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "RAYMOND",
        "middle_name": "VINCENT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bensenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.