Active NPI
Derek Goins
- Physical Therapist
- Schererville, IN
National Provider Identifier
1528144409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010304A
- Practice address
- 1505 US Highway 41
Suite A20
Schererville, IN 46375-1321 - Phone
- (219) 322-5560
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-016269 | IL | |
| Physical Therapist | 225100000X | 5388 | SC | |
| Physical Therapist | 225100000X | 05010304A | IN | Primary |
Addresses
Primary practice location
1505 US Highway 41
Suite A20
Schererville, IN 46375-1321
Mailing address
1505 US Highway 41
Suite A20
Schererville, IN 46375-1321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1505 US Hwy 41
Suite A20
Schererville, IN 46375-1394
Phone (219) 322-5560
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.32 of 100
- Quality
- 84.44
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-016269 | IL | MD | Physical Therapist |
| 05010304A | IN | MD | Physical Therapist |
| 5388 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
| Athletico LTD | Physical Therapist | Current | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560
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": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1528144409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 US HIGHWAY 41",
"address_2": "SUITE A20",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463751321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 US HIGHWAY 41",
"address_2": "SUITE A20",
"city": "SCHERERVILLE",
"state": "IN",
"postal_code": "463751321",
"telephone_number": "219-322-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOINS",
"first_name": "DEREK",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-016269",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5388",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010304A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Schererville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.