Individual provider Active NPI

Michael Pantig

  • Physical Therapist
  • Ottawa, IL
National Provider Identifier
1659848646
Registry record updated Oct 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070015386 Issued in IL
Practice address
719 Steamboat CT
Ottawa, IL 61350-9570
Phone
(909) 565-3979
NPI assigned
Oct 27, 2018
Last updated
Oct 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2018

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 070015386 IL Primary

Addresses

Primary practice location

719 Steamboat CT
Ottawa, IL 61350-9570

Mailing address

719 Steamboat CT
Ottawa, IL 61350-9570
Phone (909) 565-3979

Other practice location 1

719 Steamboat Ct
Ottawa, IL 61350-9570
Phone (909) 565-3979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220412001497 IL Practitioner - Physical Therapist in Private Practice 6002202488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

500 W Jefferson St
Suite 2310
Louisville, KY 40202-2881

PO Box
Suite 69211
Baltimore, MD 21264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Mar 31, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Mar 31, 2022 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Physical Therapist CurrentSince Mar 31, 2022 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 17, 2022 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince May 17, 2022 Accepting new patients
Empowerme Wellness Kansas City, LLC Physical Therapist CurrentSince Mar 31, 2022 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 6

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": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540598400000",
    "number": "1659848646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 STEAMBOAT CT",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613509570",
            "telephone_number": "909-565-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 STEAMBOAT CT",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613509570",
            "telephone_number": "909-565-3979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "719 Steamboat Ct",
            "address_purpose": "LOCATION",
            "city": "Ottawa",
            "state": "IL",
            "postal_code": "613509570",
            "country_code": "US",
            "telephone_number": "909-565-3979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTIG",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-27",
        "last_updated": "2018-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.