Individual provider Active NPI

Ashley Cerullo, PT

  • Physical Therapist
  • Homer Glen, IL
National Provider Identifier
1649535196
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
12261 W 159TH St
Homer Glen, IL 60491-7847
Phone
(708) 301-2255
NPI assigned
Jul 11, 2012
Last updated
Dec 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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 Primary

Addresses

Primary practice location

12261 W 159TH St
Homer Glen, IL 60491-7847

Mailing address

12261 W 159TH St
Homer Glen, IL 60491-7847
Phone (708) 301-2255

Other identifiers 2

IdentifierTypeStateIssuer
P01285698OtherILMEDICARE RAILROAD
P01190975OtherILMEDICARE RR

Other names 1

  • Ashley Roxas Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121207000294 IL Practitioner - Physical Therapist in Private Practice 4688826167 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
Orthopedic Physical Therapy Services LLCGroup PAC ID 6002942299, 9 clinicians

Practice addresses (Care Compare)

409 W Huron St
Suite 300
Chicago, IL 60654-3431
Phone (708) 301-2255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Physical Therapy Services LLC CurrentSince Dec 25, 2019 Accepting new patients

Locations

409 W Huron St
Ste 300
Chicago, IL 60654
Phone (312) 604-2562

12261 W 159th St
Lockport, IL 60491
Phone (708) 301-2255

Interoperability endpoints

  • Direct secure messaging: ashley.cerullo.1@28282.direct.athenahealth.com

Organizations & group practices 1

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1649535196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12261 W 159TH ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604917847",
            "telephone_number": "708-301-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12261 W 159TH ST",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604917847",
            "telephone_number": "708-301-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERULLO",
        "first_name": "ASHLEY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01285698",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01190975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "ROXAS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Homer Glen, IL

Sources for this page

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