Carly Michelle Machacek, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2019031259 Issued in MO

Practice address

9901 N Knoxville Ave Ste D
Peoria, IL 61615-1433

Phone

(309) 243-1989

NPI assigned

Jun 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Carly Michelle Slagel Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock Valley Physical Therapy CenterGroup PAC ID 9638087877, 232 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.

• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166
  Medicare reassignment Care Compare group NPD
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490

  Physical Therapist

  NPD
• Select Physical Therapy

  • Physical Therapist
  • Independence, MO
  • NPI 1144892233
  NPD (past)

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1700446721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 N KNOXVILLE AVE STE D",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151433",
            "telephone_number": "309-243-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHACEK",
        "first_name": "CARLY",
        "middle_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KS",
            "license": "11-06393",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2019031259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "SLAGEL",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mojolaoluwa Mabayoje
• Ashley Mabry
• Macarius, Max & Daniel, LLC (Stanton Optical)
• Jaclyn Macdonald, DMD
• Melissa Dawn Macdonald, APRN, CNP
• Nancy Machens
• Andrea N Machnacki, APRN, CNP
• Amias Joseph Mackenzie
• Joseph Richard Mackey, M.D.
• Rosewell Valentino Mackey, MD

• Orthopedic Physical Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Orthopedic Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.