Individual provider Active NPI

Nilesh Gangan

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1669947693
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4950 E Stop 11 Rd Ste B
Indianapolis, IN 46237-9104
Phone
(317) 859-5857
Fax
(317) 865-2265
NPI assigned
Oct 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 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

4950 E Stop 11 Rd Ste B
Indianapolis, IN 46237-9104

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017001196 IN Practitioner - Physical Therapist in Private Practice 1658623855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Therapy LLCGroup PAC ID 6002959525, 170 clinicians

Practice addresses (Care Compare)

4950 E Stop 11 Rd
Suite B
Indianapolis, IN 46237-9104
Phone (317) 859-5857

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 5, 2018 Accepting new patients
Advanced Physical Therapy, LLC Physical Therapist CurrentSince Sep 5, 2018 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2421 N Morton St
Franklin, IN 46131
Phone (317) 738-4401

120 W Smith Valley Rd
Ste C
Greenwood, IN 46142
Phone (317) 807-0223

4625 S Emerson Ave
Indianapolis, IN 46203
Phone (317) 522-2303

4950 E Stop 11 Rd
Ste B
Indianapolis, IN 46237
Phone (317) 859-5857

5949 W Raymond St
Indianapolis, IN 46241
Phone (317) 247-1579

8936 Southpointe Dr
Ste A1
Indianapolis, IN 46227
Phone (317) 888-3838

310 Duran Dr
Shelbyville, IN 46176
Phone (317) 421-0244

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": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1669947693",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 E STOP 11 RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462379104",
            "telephone_number": "317-859-5857",
            "fax_number": "317-865-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGAN",
        "first_name": "NILESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.