Individual provider Active NPI

Jocelyn Carrillo, DPT

  • Physical Therapist
  • Clinton Township, MI
National Provider Identifier
1396499505
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
42615 Garfield Rd
Clinton Township, MI 48038-1653
Phone
(586) 286-8280
Fax
(586) 286-0427
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

42615 Garfield Rd
Clinton Township, MI 48038-1653

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

1275 N Convent St Ste 3
Bourbonnais, IL 60914-8211
Phone (815) 936-1855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220214000792 IL Practitioner - Physical Therapist in Private Practice 3173916244 Reassigns benefits to 2 organizations
I20230906001326 MI Practitioner - Physical Therapist in Private Practice 3173916244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neil King Physical Therapy, PCGroup PAC ID 4385722917, 32 clinicians

Practice addresses (Care Compare)

22237 Greater Mack Ave
Saint Clair Shores, MI 48080-2357
Phone (586) 204-5885

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
89.5
Improvement activities
40
Cost
71.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Naperville, LLC CurrentSince Feb 22, 2022 Accepting new patients
Neil King Physical Therapy, PC Physical Therapist CurrentSince Nov 27, 2023 Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jan 10, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville LLC Physical Therapist CurrentSince Feb 22, 2022 Accepting new patients
Back to You Rehab PLLC Physical Therapist Past Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

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

800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

15850 Cicero Ave
Oak Forest, IL 60452
Phone (708) 224-2555

2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270

967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237

109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251

0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743

141 Hampton Cir
Rochester Hills, MI 48307
Phone (248) 583-7555

22237 Greater Mack Ave
Saint Clair Shores, MI 48080
Phone (586) 204-5885

Organizations & group practices 7

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": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1396499505",
    "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": "42615 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381653",
            "telephone_number": "586-286-8280",
            "fax_number": "586-286-0427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1275 N Convent St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Bourbonnais",
            "state": "IL",
            "postal_code": "609148211",
            "country_code": "US",
            "telephone_number": "815-936-1855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JOCELYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.