Alexis Jimenez, PSYD, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009726 Issued in IL

Practice address

621 Springwood Dr
Joliet, IL 60431-8993

Phone

(773) 680-2111

NPI assigned

May 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baal Perazim Wellness IncGroup PAC ID 7618218587, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Baal Perazim Wellness, Inc

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1215403530
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1699412155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SPRINGWOOD DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318993",
            "telephone_number": "773-680-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SPRINGWOOD DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318993",
            "telephone_number": "773-680-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "PSYD, LCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Grace Jessen, APRN
• Mickey B Jester, D.O.
• Kenneth Paul Jesunas, M.D.
• Tamra Jetter
• Basant K Jhawar, M.D.
• Steven Jiotis, MD
• Joanne E Hattendorf Ed D LLC
• Alexandra Rose Johnson, PA-C
• Alisa Johnson, HIS
• Bridget Johnson, O.T.

• Clinical Psychologist in Joliet, IL
• Providers in Joliet, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.