Individual provider Active NPI

Roselyn Sevilla Ramos, PHYSICAL THERAPIST

  • Physical Therapist
  • Normal, IL
National Provider Identifier
1437792124
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-007616 Issued in IL
Practice address
510 Broadway
Normal, IL 61761-3762
Phone
(309) 452-4406
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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 070-007616 IL Primary

Addresses

Primary practice location

510 Broadway
Normal, IL 61761-3762

Mailing address

510 Broadway
Normal, IL 61761-3762
Phone (309) 452-4406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210104002290 IL Practitioner - Physical Therapist in Private Practice 5799198149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-007616ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 11, 2020 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 11, 2020 Accepting new patients
Rehabcare Group East, LLC Past Accepting new patients
Preferred Podiatry Group PC Past Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1437792124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 BROADWAY",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613762",
            "telephone_number": "309-452-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BROADWAY",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613762",
            "telephone_number": "309-452-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "ROSELYN",
        "middle_name": "SEVILLA",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-007616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.