Individual provider Active NPI

Manuel Gallegos

  • Physical Therapist
  • Frisco, TX
National Provider Identifier
1619703402
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1555 US Highway 380 Ste 900
Frisco, TX 75033-0178
Phone
(972) 346-5634
NPI assigned
Sep 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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

1555 US Highway 380 Ste 900
Frisco, TX 75033-0178

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008004369 TX Practitioner - Physical Therapist in Private Practice 7911438411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians

Practice addresses (Care Compare)

8845 Gary Burns Dr
Suite 100
Frisco, TX 75034-2503
Phone (972) 979-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Aug 13, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 13, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1267 W Exchange Pkwy
Ste 150
Allen, TX 75013
Phone (469) 342-0641

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

6828 Stonebrook Pkwy
Ste 300
Frisco, TX 75034
Phone (469) 403-2022

1555 US Highway 380
Ste 900
Frisco, TX 75033
Phone (972) 346-5634

8845 Gary Burns Dr
Ste 100
Frisco, TX 75034
Phone (469) 403-2090

2180 FM 423
Ste 300
Little Elm, TX 75068
Phone (469) 403-2242

3520 W University Dr
Ste 201
McKinney, TX 75071
Phone (469) 307-5674

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

3751 Main St
Ste 100
The Colony, TX 75056
Phone (469) 476-3523

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1619703402",
    "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",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 US HIGHWAY 380 STE 900",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330178",
            "telephone_number": "972-346-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.