Individual provider Active NPI

Sonya Myscofski

  • Physical Therapist
  • Bloomington, IL
National Provider Identifier
1457130734
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2103 N Veterans Pkwy Ste 328
Bloomington, IL 61704-0919
Phone
(309) 948-6469
NPI assigned
Sep 26, 2023
Last updated
Sep 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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

2103 N Veterans Pkwy Ste 328
Bloomington, IL 61704-0919

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (888) 830-4125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023001380 IL Practitioner - Physical Therapist in Private Practice 7719410265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Therapy Services IncGroup PAC ID 0345145843, 17 clinicians

Practice addresses (Care Compare)

1201 N Cummings LN
Washington, IL 61571-9267
Phone (309) 886-2305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Therapy Services, Inc Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC PastSince Oct 1, 2023 Accepting new patients

Locations

2900 Frank Scott Pkwy W
Ste 930
Belleville, IL 62223
Phone (618) 222-9383

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

1201 N Cummings Ln
Washington, IL 61571
Phone (309) 444-2090

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1457130734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 N VETERANS PKWY STE 328",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040919",
            "telephone_number": "309-948-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSCOFSKI",
        "first_name": "SONYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.