Stephanie J Carlson, DPT

Individual provider Active NPI Physical Therapist · Rockton, IL

NPI 1487938304 · NPPES record last updated Aug 11, 2023

Key facts

NPI
1487938304
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070018761 (IL)
Practice address
330 E Main St
Rockton, IL 61072-2501
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 23

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.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLC (531 clinicians)

Practice addresses (Care Compare)

5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone (815) 398-9491

770 Beloit Rd
Belvidere, IL 61008-1745
Phone (815) 398-9491

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100 (group)
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20111212000925 IL Practitioner - Physical Therapist in Private Practice 7012182520 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
070018761ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Physical Therapist Current
since Jan 7, 2019
Accepting new patients
Orthomidwest, PLLC Current
since Jan 7, 2019
Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

330 E Main St
Rockton, IL 61072
Phone (815) 624-0235

330 E Main St
Ste 300
Rockton, IL 61072

Interoperability endpoints

  • Direct secure messaging: stephanie.carlson@ro.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070018761 IL Yes

Addresses

Primary practice location

330 E Main St
Rockton, IL 61072-2501

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Other names

  • Stephanie J Nedved Former name

Other providers in Rockton, IL

All providers in Rockton, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.