Individual provider Active NPI

Shayan Moslemi, DPT

  • Physical Therapist
  • The Colony, TX
National Provider Identifier
1821471004
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1264416 Issued in TX
Practice address
3751 Main St Ste 100
The Colony, TX 75056-4133
Phone
(469) 476-3523
Fax
(972) 845-7418
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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 1264416 TX Primary

Addresses

Primary practice location

3751 Main St Ste 100
The Colony, TX 75056-4133

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Other practice location 1

2119 E Hatch Rd Ste A
Modesto, CA 95351-4814
Phone (209) 803-9163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151215000915 TX Practitioner - Physical Therapist in Private Practice 8022319136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 W Sam Houston Pkwy S
Suite 300
Houston, TX 77042-2453

600 Oakmont LN
Suite 600C
Westmont, IL 60559-5548

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1264416TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Physical Therapy Professional Corporation Physical Therapist Current Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Feb 17, 2017 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Feb 17, 2017 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

5615 Colleyville Blvd
Ste 130
Colleyville, TX 76034
Phone (817) 576-0995

125 N MacArthur Blvd
Irving, TX 75061
Phone (972) 887-3318

1821 N Lake Forest Dr
Ste 300
McKinney, TX 75071
Phone (469) 219-3707

4001 W 15th St
Ste 490
Plano, TX 75093
Phone (469) 416-5250

3751 Main St
Ste 100
The Colony, TX 75056
Phone (469) 476-3523

Organizations & group practices 5

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1821471004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 MAIN ST STE 100",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750564133",
            "telephone_number": "469-476-3523",
            "fax_number": "972-845-7418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2119 E Hatch Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953514814",
            "country_code": "US",
            "telephone_number": "209-803-9163",
            "fax_number": "209-622-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEMI",
        "first_name": "SHAYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1264416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Colony, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.