Individual provider Active NPI

Mai Ahmed, PHYSICAL THERAPIST

  • Physical Therapist
  • Munster, IN
National Provider Identifier
1780336552
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.026363 Issued in IL
Practice address
8159 Calumet Ave
Munster, IN 46321-1701
Phone
(219) 836-2800
NPI assigned
Jan 24, 2022
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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 070.026363 IL Primary

Addresses

Primary practice location

8159 Calumet Ave
Munster, IN 46321-1701

Mailing address

570 Village Center Dr Ste 205
Burr Ridge, IL 60527-4526
Phone (630) 920-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220225002377 IL Practitioner - Physical Therapist in Private Practice 5496149973 Reassigns benefits to 1 organization
I20220302001844 IN Practitioner - Physical Therapist in Private Practice 5496149973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy PCGroup PAC ID 0446214845, 12 clinicians

Practice addresses (Care Compare)

14474 S la Grange Rd
Orland Park, IL 60462-2506
Phone 63092046706

8159 Calumet Ave
Munster, IN 46321-1701
Phone (630) 920-4670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.026363ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy PC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

570 Village Center Dr
Ste 205
Burr Ridge, IL 60527

1850 W Winchester Rd
Ste 223
Libertyville, IL 60048
Phone (847) 680-3020

14474 S La Grange Rd
Orland Park, IL 60462
Phone (708) 460-8080

8159 Calumet Ave
Munster, IN 46321
Phone (219) 836-2800

Organizations & group practices 1

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": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1780336552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 VILLAGE CENTER DR STE 205",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605274526",
            "telephone_number": "630-920-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8159 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-836-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MAI",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.026363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.