Individual provider Active NPI

Hemal Modi, P.T.

  • Physical Therapist
  • Des Plaines, IL
National Provider Identifier
1700859428
Registry record updated Mar 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070011869 Issued in IL
Practice address
9301 Golf Rd
Des Plaines, IL 60016-1667
Phone
(184) 739-1972
Fax
(773) 767-3944
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2010

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 070011869 IL Primary

Addresses

Primary practice location

9301 Golf Rd
Des Plaines, IL 60016-1667

Mailing address

9301 Golf Rd
Des Plaines, IL 60016-1667
Phone (184) 739-1972

Other identifiers 1

IdentifierTypeStateIssuer
01635425OtherILBC/BS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000331 IL Practitioner - Physical Therapist in Private Practice 9739122672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Physical Therapy, Inc.Group PAC ID 8820022098, 2 clinicians

Practice addresses (Care Compare)

9301 Golf Rd
Suite 204
Des Plaines, IL 60016-1687
Phone (847) 391-9720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Physical Therapy, Inc. Physical Therapist CurrentSince Jul 1, 2005 Accepting new patients
Foot and Ankle Surgery Facility, LTD Physical Therapist Past Accepting new patients
Lake County Physical Therapy LLC Physical Therapist PastSince Sep 15, 2018 Accepting new patients
Dynacare Physical Therapy Physical Therapist Past Accepting new patients

Locations

9301 Golf Rd
Ste 204
Des Plaines, IL 60016
Phone (847) 297-3347

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aquarius Home Care, LLCWarren, MI, CCN 239034 Home health agency Other Jan 17, 2024
Avotre Home Health, Inc.Des Plaines, IL, CCN 148382 Home health agency 5% Or Greater Direct Ownership Interest (5%) Mar 22, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269561600000",
    "number": "1700859428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 GOLF RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161667",
            "telephone_number": "184-739-1972",
            "fax_number": "773-767-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 GOLF RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161667",
            "telephone_number": "184-739-1972",
            "fax_number": "773-767-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "HEMAL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2010-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "01635425",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.