Individual provider Active NPI

Jason R Delaney, PT

  • Physical Therapist
  • Columbia, IL
National Provider Identifier
1720354889
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070011363 Issued in IL
Practice address
1000 Eleven S Ste 1B
Columbia, IL 62236-1078
Phone
(618) 281-9699
Fax
(618) 281-9698
NPI assigned
Mar 22, 2012
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 070011363 IL Primary

Addresses

Primary practice location

1000 Eleven S Ste 1B
Columbia, IL 62236-1078

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

20 Professional Park Dr
Suite B
Maryville, IL 62062-5830
Phone (618) 205-3655

Other identifiers 1

IdentifierTypeStateIssuer
1720354889OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000658 IL Practitioner - Physical Therapist in Private Practice 5193976652 Reassigns benefits to 2 organizations
Practice locations: Smithton, IL

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.61 of 100Reported as group
Quality
90
Improvement activities
40
Cost
70.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070011363ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
Athletic & Therapeutic Institute of Bourbonnais, LLC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
Delaney Therapy Innovations CurrentSince Jan 24, 2021 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Mar 16, 2025 Accepting new patients
Athletic and Therapeutic Institute of Bourbonnais, LLC Physical Therapist Current Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Mar 16, 2025 Accepting new patients

Locations

383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367

790 Remington Blvd
Bolingbrook, IL 60440

1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855

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

1000 Eleven S
Ste 1B
Columbia, IL 62236
Phone (618) 281-9699

2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612

13 S Main St
Ste 1
Smithton, IL 62285
Phone (618) 416-5388

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1720354889",
    "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",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELEVEN S STE 1B",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361078",
            "telephone_number": "618-281-9699",
            "fax_number": "618-281-9698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Professional Park Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625830",
            "country_code": "US",
            "telephone_number": "618-205-3655",
            "fax_number": "618-628-0883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELANEY",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1720354889",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.