Individual provider Active NPI

Meena Venkatreddy

  • Physical Therapist
  • Grand Prairie, TX
National Provider Identifier
1588341879
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
620 W Westchester Pkwy Apt 10208
Grand Prairie, TX 75052-3276
Phone
(469) 756-8307
NPI assigned
Jun 29, 2023
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 NU Primary

Addresses

Primary practice location

620 W Westchester Pkwy Apt 10208
Grand Prairie, TX 75052-3276

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230811002082 TX Practitioner - Physical Therapist in Private Practice 3779945464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 William D Tate Ave
Suite 300
Grapevine, TX 76051-4024
Phone (817) 527-3377

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Aug 22, 2023 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 22, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

3000 FM 407 E
Ste 500
Bartonville, TX 76226
Phone (940) 448-2007

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

5017 Teasley Ln
Ste 161
Denton, TX 76210
Phone (940) 220-2283

1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947

217 E Bonds Ranch Rd
Fort Worth, TX 76131
Phone (682) 285-9310

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

4617 W Bailey Boswell Rd
Fort Worth, TX 76179
Phone (682) 350-4106

7260 Blue Mound Rd
Ste 146
Fort Worth, TX 76131
Phone 68228593508830

1401 William D Tate Ave
Ste 300
Grapevine, TX 76051
Phone (817) 527-3377

1288 W Main St
Ste 148
Lewisville, TX 75067
Phone (469) 496-3992

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1588341879",
    "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": "620 W WESTCHESTER PKWY APT 10208",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523276",
            "telephone_number": "469-756-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATREDDY",
        "first_name": "MEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.