Individual provider Active NPI

Yelena C Enwere, PT

  • Physical Therapist
  • Addison, TX
National Provider Identifier
1609272392
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1243367 Issued in TX
Practice address
17051 Dallas Pkwy
Suite 450
Addison, TX 75001-7109
Phone
(469) 416-5250
Fax
(469) 416-5260
NPI assigned
Nov 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 1243367 TX Primary

Addresses

Primary practice location

17051 Dallas Pkwy
Suite 450
Addison, TX 75001-7109

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
I20150202000735 TX Practitioner - Physical Therapist in Private Practice 7416272018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1060 N Main St
Suite 101
Euless, TX 76039-3366
Phone (469) 498-2855

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

State licenses

LicenseStateTypeSpecialty
1243367TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Oct 13, 2014 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Oct 13, 2014 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

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

5335 W Sublett Rd
Ste 151
Arlington, TX 76017
Phone (817) 839-9150

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

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

607 S Cedar Ridge Dr
Unit 102
Duncanville, TX 75137
Phone (214) 742-8560

1060 N Main St
Ste 101
Euless, TX 76039
Phone (469) 498-2855

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

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

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": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1609272392",
    "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": "17051 DALLAS PKWY",
            "address_2": "SUITE 450",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017109",
            "telephone_number": "469-416-5250",
            "fax_number": "469-416-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENWERE",
        "first_name": "YELENA",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1243367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.