Individual provider Active NPI

Michael Stapleton, MPT

  • Physical Therapist
  • Lindenhurst, IL
National Provider Identifier
1659414894
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015417 Issued in IL
Practice address
3021 Falling Waters Blvd Ste B
Lindenhurst, IL 60046-6745
Phone
(847) 356-2895
Fax
(847) 356-2919
NPI assigned
Feb 15, 2007
Last updated
May 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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 070015417 IL Primary

Addresses

Primary practice location

3021 Falling Waters Blvd Ste B
Lindenhurst, IL 60046-6745

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

8937 Grand Ave
River Grove, IL 60171-3603
Phone (708) 453-1354

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120724000630 IL Practitioner - Physical Therapist in Private Practice 5799941449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3021 Falling Waters Blvd
Suite C
Lindenhurst, IL 60046-6745
Phone (847) 356-2895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC CurrentSince May 22, 2023 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince May 22, 2023 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jul 1, 2012 Accepting new patients
North Suburban Physical Therapy, P.C. Physical Therapist PastSince May 28, 2023 Accepting new patients

Locations

204 E Washington St
Clinton, IL 61727
Phone (217) 570-0225

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

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

799 Central Ave
Ste 210
Highland Park, IL 60035
Phone (847) 433-5502

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

3021 Falling Waters Blvd
Ste C
Lindenhurst, IL 60046
Phone (847) 245-3670

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

1002 S Elmhurst Rd
Mt Prospect, IL 60056
Phone (224) 205-3811

840 Willow Rd
Ste P
Northbrook, IL 60062
Phone (224) 649-5600

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

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

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, 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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1659414894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 FALLING WATERS BLVD STE B",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600466745",
            "telephone_number": "847-356-2895",
            "fax_number": "847-356-2919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8937 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "River Grove",
            "state": "IL",
            "postal_code": "601713603",
            "country_code": "US",
            "telephone_number": "708-453-1354",
            "fax_number": "708-453-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "MICHAEL",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.