Active NPI
Alex Fogt, DPT
- Physical Therapist
- Goodyear, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- CP011725T
- Practice address
- 380 N Estrella Pkwy Ste A1
Goodyear, AZ 85338-2885 - Phone
- (623) 322-0654
- Fax
- (623) 322-0664
- NPI assigned
- Aug 14, 2019
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | LPT-32055 | AZ | |
| Physical Therapist | 225100000X | PT210002132 | DC | |
| Physical Therapist | 225100000X | 05014613A | IN | |
| Physical Therapist | 225100000X | PT018257 | OH | |
| Physical Therapist | 225100000X | CP011725T | MD | Primary |
Addresses
Primary practice location
380 N Estrella Pkwy Ste A1
Goodyear, AZ 85338-2885
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206
Other practice location 1
962 Wayne Ave Ste L-D
Silver Spring, MD 20910-4433
Phone (301) 650-0036
Other practice location 2
4375 E Indian School Rd Ste 190
Phoenix, AZ 85018-5336
Phone (602) 789-3880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 86.09 of 100
- Quality
- 89.13
- Improvement activities
- 40
- Cost
- 73.57
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT210002132 | DC | MD | Physical Therapist |
| CP011725T | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare & Rehab, LLC | Physical Therapist | Current | Accepting new patients |
| Ideal Rehabilitation LLC | Past | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
962 Wayne Ave
Ste Ld
Silver Spring, MD 20910
Phone (301) 650-0036
1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500
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.
-
- Durable Medical Equipment & Medical Supplies
- Tucson, AZ
- NPI 1831353614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672617600000",
"number": "1528614781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "866-370-8206",
"fax_number": "517-435-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 N ESTRELLA PKWY STE A1",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853382885",
"telephone_number": "623-322-0654",
"fax_number": "623-322-0664"
}
],
"practiceLocations": [
{
"address_1": "962 Wayne Ave Ste L-D",
"address_purpose": "LOCATION",
"city": "Silver Spring",
"state": "MD",
"postal_code": "209104433",
"country_code": "US",
"telephone_number": "301-650-0036",
"fax_number": "301-650-0038",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4375 E Indian School Rd Ste 190",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850185336",
"country_code": "US",
"telephone_number": "602-789-3880",
"fax_number": "602-362-5393",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOGT",
"first_name": "ALEX",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2023-01-02",
"certification_date": "2023-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-32055",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT210002132",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05014613A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT018257",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "CP011725T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.