Individual provider Active NPI

Michelle Carlevato, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1528182136
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5414 N Broadway St
Chicago, IL 60640-1704
Phone
(773) 907-3599
NPI assigned
Mar 19, 2007
Last updated
Apr 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 IL Primary

Addresses

Primary practice location

5414 N Broadway St
Chicago, IL 60640-1704

Mailing address

5414 N Broadway St
Chicago, IL 60640-1704
Phone (773) 907-3599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080703000607 IL Practitioner - Physical Therapist in Private Practice 0648342881 Reassigns benefits to 1 organization

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
Simply Home Physical Therapy LLCGroup PAC ID 4385041938, 2 clinicians

Practice addresses (Care Compare)

419 Ridge Ave
Clarendon Hills, IL 60514-2705
Phone (630) 908-7881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070015616ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Home Physical Therapy LLC Physical Therapist CurrentSince Jul 5, 2021 Accepting new patients
Andersonville Physical Therapy, SC Physical Therapist PastSince Aug 1, 2001 Accepting new patients

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1528182136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401704",
            "telephone_number": "773-907-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401704",
            "telephone_number": "773-907-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLEVATO",
        "first_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; 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.