Individual provider Active NPI

Alycia Bukartek

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1730941196
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
18561 N 59TH Ave Ste 117
Glendale, AZ 85308-1256
Phone
(602) 313-4089
Fax
(623) 322-0664
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 AZ Primary

Addresses

Primary practice location

18561 N 59TH Ave Ste 117
Glendale, AZ 85308-1256

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318000500 AZ Practitioner - Physical Therapist in Private Practice 1456798149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
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)

18561 N 59TH Ave
Suite 117
Glendale, AZ 85308-1256
Phone (623) 322-0654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Apr 8, 2024 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

960 E Warner Rd
Ste 7
Chandler, AZ 85225
Phone (480) 417-4930

18561 N 59th Ave
Ste 117
Glendale, AZ 85308
Phone (602) 313-4089

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

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

790 Remington Blvd
Bolingbrook, IL 60440

Organizations & group practices 2

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1730941196",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18561 N 59TH AVE STE 117",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081256",
            "telephone_number": "602-313-4089",
            "fax_number": "623-322-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKARTEK",
        "first_name": "ALYCIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.