Individual provider Active NPI

Jonathan Eng

  • Physical Therapist
  • Green Valley, AZ
National Provider Identifier
1679272413
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
18773 S Nogales Hwy Ste 105
Green Valley, AZ 85614-0403
Phone
(520) 477-3130
Fax
(480) 885-1788
NPI assigned
Mar 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X AZ Primary
Physical Therapist 225100000X 29326 MD
Physical Therapist 225100000X CP021791T DE
Physical Therapist 225100000X CP032875T CO
Physical Therapist 225100000X

Addresses

Primary practice location

18773 S Nogales Hwy Ste 105
Green Valley, AZ 85614-0403

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

29 Atlantic Ave
Ocean View, DE 19970-9155
Phone (302) 541-5705

Other practice location 2

803 Lamoka Dr
Odenton, MD 21113-3663
Phone (866) 370-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE, AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230412001250 MD Practitioner - Physical Therapist in Private Practice 9830564467 Reassigns benefits to 2 organizations
I20230606000865 DE Practitioner - Physical Therapist in Private Practice 9830564467 Reassigns benefits to 1 organization
I20240424003304 AZ Practitioner - Physical Therapist in Private Practice 9830564467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

18773 S Nogales Hwy
Suite 105
Green Valley, AZ 85614-0403
Phone (520) 477-3130

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP032875TCOMDPhysical Therapist
CP021791TDEMDPhysical Therapist
29326MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Apr 15, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 27, 2023 Accepting new patients
Dynamic Therapy Services, LLC Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Dynamic Therapy Services LLC Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 27, 2023 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

18773 S Nogales Hwy
Ste 105
Green Valley, AZ 85614
Phone (520) 477-3130

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

5110 S Rural Rd
Ste 104
Tempe, AZ 85282
Phone (480) 629-5549

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

29 Atlantic Ave
Ocean View, DE 19970
Phone (302) 541-5705

790 Remington Blvd
Bolingbrook, IL 60440

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1679272413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18773 S NOGALES HWY STE 105",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140403",
            "telephone_number": "520-477-3130",
            "fax_number": "480-885-1788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Ocean View",
            "state": "DE",
            "postal_code": "199709155",
            "country_code": "US",
            "telephone_number": "302-541-5705",
            "fax_number": "302-541-5706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "803 Lamoka Dr",
            "address_purpose": "LOCATION",
            "city": "Odenton",
            "state": "MD",
            "postal_code": "211133663",
            "country_code": "US",
            "telephone_number": "866-370-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENG",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29326",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "CP021791T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP032875T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.