Individual provider Active NPI

Chase Wattenbarger

  • Physical Therapist
  • Madison, IN
National Provider Identifier
1558044958
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
130 Elmhurst Dr
Madison, IN 47250-2912
Phone
(812) 701-4418
NPI assigned
Aug 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 Primary

Addresses

Primary practice location

130 Elmhurst Dr
Madison, IN 47250-2912

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822001104 IN Practitioner - Physical Therapist in Private Practice 9537521695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

1312 W Arch Haven Ave
BLDG 1320 Suite E
Bloomington, IN 47403-2088
Phone (812) 336-8406

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 3, 2023 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Aug 3, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

1312 W Arch Haven Ave
Ste E
Bloomington, IN 47403
Phone (812) 336-8406

2488 S Walnut St
Bloomington, IN 47401
Phone (812) 287-8044

4265 N Cypress Ln
Bloomington, IN 47404
Phone (812) 727-0047

1675 N National Rd
Columbus, IN 47201
Phone (812) 799-1257

1675 N National Rd
Ste D
Columbus, IN 47201
Phone (812) 799-1257

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

369 Grand Valley Blvd
Martinsville, IN 46151
Phone (765) 349-9255

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1558044958",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ELMHURST DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472502912",
            "telephone_number": "812-701-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTENBARGER",
        "first_name": "CHASE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.