Individual provider Active NPI

Anthony Stuart Gravin, DPT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1649640988
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.021832 Issued in IL
Practice address
412 W 31St St
Chicago, IL 60616-3116
Phone
(312) 225-3119
NPI assigned
Sep 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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 070.021832 IL Primary

Addresses

Primary practice location

412 W 31St St
Chicago, IL 60616-3116

Mailing address

1419 W George St
Chicago, IL 60657-4103
Phone (916) 505-3101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629001815 CA Practitioner - Physical Therapist in Private Practice 7911204391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

9852 Business Park Dr
Suite a
Sacramento, CA 95827-1709
Phone (916) 362-7962

Merit-based Incentive Payment System (MIPS)

Final score
47.57 of 100Reported as individual
Quality
38.31
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
76.21 of 100Reported as group
Quality
38.71
Promoting interoperability
100
Improvement activities
40
Cost
68.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.021832ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Sep 19, 2016 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 4, 2023 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 4, 2023 Accepting new patients
Western Physical Therapy Inc CurrentSince Sep 19, 2016 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

5525 Dewey Dr
Ste 202
Fair Oaks, CA 95628
Phone (916) 536-9130

1516 State Highway 99
Ste G
Gridley, CA 95948
Phone (530) 846-8018

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

10255 Live Oak Blvd
Live Oak, CA 95953
Phone (530) 695-3700

6125 King Rd
Ste 102
Loomis, CA 95650
Phone (916) 652-5700

7281 Lone Pine Dr
Ste D103
Rancho Murieta, CA 95683
Phone (916) 354-0719

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

1020 29th St
Ste 340
Sacramento, CA 95816
Phone (916) 980-8858

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

5850 Canoga Ave
Ste 120
Woodland Hills, CA 91367
Phone (747) 255-4089

1528 Plumas Ct
Ste 200
Yuba City, CA 95991
Phone (530) 434-6256

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": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1649640988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 W GEORGE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574103",
            "telephone_number": "916-505-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W 31ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163116",
            "telephone_number": "312-225-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVIN",
        "first_name": "ANTHONY",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-29",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.021832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.