Individual provider Active NPI

Opeyemi Adesina

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1508664681
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3510 Portage Rd Ste a
South Bend, IN 46628-6091
Phone
(574) 203-9527
Fax
(574) 203-9528
NPI assigned
Mar 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 IN Primary

Addresses

Primary practice location

3510 Portage Rd Ste a
South Bend, IN 46628-6091

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250318002426 IN Practitioner - Physical Therapist in Private Practice 4183146269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Therapy LLCGroup PAC ID 6002959525, 170 clinicians

Practice addresses (Care Compare)

3510 Portage Rd
South Bend, IN 46628-6091
Phone (574) 203-9527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Mar 3, 2025 Accepting new patients

Locations

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

3510 Portage Rd
#A
South Bend, IN 46628
Phone (574) 203-9527

3510 Portage Rd
South Bend, IN 46628
Phone (574) 203-9527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1508664681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 PORTAGE RD STE A",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466286091",
            "telephone_number": "574-203-9527",
            "fax_number": "574-203-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADESINA",
        "first_name": "OPEYEMI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.