Individual provider Active NPI

Julie Anne McCormack, MPT

  • Physical Therapist
  • Anderson, IN
National Provider Identifier
1740502913
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05004144A Issued in IN
Practice address
1118 W Cross St
Anderson, IN 46011-9530
Phone
(765) 643-5000
NPI assigned
Feb 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 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 05004144A IN Primary

Addresses

Primary practice location

1118 W Cross St
Anderson, IN 46011-9530

Mailing address

1987 E 500 S
Anderson, IN 46013-9602
Phone (765) 779-4394

Other names 1

  • Miss Julie Anne Roskowski Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217002242 IN Practitioner - Physical Therapist in Private Practice 3173935061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

3911 W Clara LN
Muncie, IN 47304-5412
Phone (765) 587-0241

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05004144AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Physical Therapist CurrentSince Dec 1, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients
Creative Health Care Management LLC Physical Therapist CurrentSince Dec 1, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jan 17, 2022 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

3911 W Clara Ln
Muncie, IN 47304
Phone (765) 288-8800

10 S 9th St
Ste 4
Noblesville, IN 46060

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

1940 E Tipton St
Ste C
Seymour, IN 47274
Phone (812) 271-0042

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": "1266192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1740502913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 E 500 S",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460139602",
            "telephone_number": "765-779-4394",
            "fax_number": "765-779-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 W CROSS ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460119530",
            "telephone_number": "765-643-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-15",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004144A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ROSKOWSKI",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anderson, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; 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.