Individual provider Active NPI

Ryan Heilman, DPT

  • Physical Therapist
  • Monroe, WI
National Provider Identifier
1619304599
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070021940 Issued in IL
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(218) 839-0181
NPI assigned
Oct 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12268-24 WI
Physical Therapist 225100000X 9025 MN
Physical Therapist 225100000X 070021940 IL Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

515 22ND Ave
Monroe, WI 53566-1569
Phone (218) 839-0181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180212002740 IL Practitioner - Physical Therapist in Private Practice 2365702321 Reassigns benefits to 2 organizations
I20210315002071 WI Practitioner - Physical Therapist in Private Practice 2365702321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Therapists LTD.Group PAC ID 0648286070, 3 clinicians

Practice addresses (Care Compare)

2737 Prairie Ave
Beloit, WI 53511-2246
Phone (608) 299-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12268-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Therapists LTD. Physical Therapist CurrentSince Dec 10, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 11, 2018 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Sep 5, 2018 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Sep 5, 2018 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 11, 2018 Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

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

6502 Joliet Rd
Ste B
Countryside, IL 60525
Phone (708) 352-0547

2595 E Division St
Diamond, IL 60416
Phone (815) 634-8420

1294 S US Highway 12
Fox Lake, IL 60020
Phone (847) 973-9440

280 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 854-8219

546 N Rand Rd
Lake Zurich, IL 60047
Phone (847) 438-6624

300 S State St
Marengo, IL 60152
Phone (815) 568-4550

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

201 E US Route 6
Morris, IL 60450
Phone (815) 416-0046

1186 W Maple Ave
Mundelein, IL 60060
Phone (847) 970-7099

722 N McLean Blvd
South Elgin, IL 60177
Phone (847) 695-5088

Organizations & group practices 5

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": "1381276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1619304599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "218-839-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "218-839-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILMAN",
        "first_name": "RYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-09",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12268-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9025",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.