Individual provider Active NPI

Melissa Buckley, PT, MSPT, DPT

  • Physical Therapist
  • Geneva, IL
National Provider Identifier
1578604757
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010829 Issued in IL
Practice address
2425 Fargo Blvd
Geneva, IL 60134-3591
Phone
(630) 232-2200
NPI assigned
Feb 9, 2007
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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 070010829 IL Primary

Addresses

Primary practice location

2425 Fargo Blvd
Geneva, IL 60134-3591

Mailing address

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

Other practice location 1

722 N McLean Blvd
South Elgin, IL 60177-1429
Phone (847) 695-0355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040121000375 IL Practitioner - Physical Therapist in Private Practice 4789586835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

2425 Fargo Blvd
Geneva, IL 60134-3591
Phone (630) 232-2200

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Apr 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince Apr 1, 2019 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

2425 Fargo Blvd
Geneva, IL 60134
Phone (630) 232-2200

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1578604757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 FARGO BLVD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343591",
            "telephone_number": "630-232-2200",
            "fax_number": "630-232-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 FARGO BLVD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601343591",
            "telephone_number": "630-232-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "722 N McLean Blvd",
            "address_purpose": "LOCATION",
            "city": "South Elgin",
            "state": "IL",
            "postal_code": "601771429",
            "country_code": "US",
            "telephone_number": "847-695-0355",
            "fax_number": "847-695-8365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "MELISSA",
        "credential": "PT, MSPT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.