Individual provider Active NPI

Jisha Varughese, DPT

  • Physical Therapist
  • Laveen, AZ
National Provider Identifier
1821795931
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-034130 Issued in AZ
Practice address
5885 W Baseline Rd Ste 110
Laveen, AZ 85339-3097
Phone
(602) 830-9083
Fax
(602) 281-7247
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 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 LPT-034130 AZ Primary

Addresses

Primary practice location

5885 W Baseline Rd Ste 110
Laveen, AZ 85339-3097

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other practice location 1

1065 E Tucson Marketplace Blvd Ste 155
Tucson, AZ 85713-6563
Phone (520) 719-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241121004591 TX Practitioner - Physical Therapist in Private Practice 6204200082 Reassigns benefits to 1 organization
I20250429003595 AZ Practitioner - Physical Therapist in Private Practice 6204200082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1065 E Tucson Marketplace Blvd
Suite 155
Tucson, AZ 85713-6563
Phone (520) 822-8640

5885 W Baseline Rd
Laveen, AZ 85339-3096
Phone (602) 830-9083

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-034130AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC CurrentSince Oct 21, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Apr 28, 2025 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients
Athletico LTD Physical Therapist PastSince Nov 7, 2025 Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

6070 W Bell Rd
Ste A103
Glendale, AZ 85308
Phone (602) 782-3965

5885 W Baseline Rd
Ste 110
Laveen, AZ 85339
Phone (602) 830-9083

5885 W Baseline Rd
Laveen, AZ 85339
Phone (602) 830-9083

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

8270 S Houghton Rd
Ste 180
Tucson, AZ 85747
Phone (520) 664-1430

1065 E Tucson Marketplace Blvd
Ste 155
Tucson, AZ 85713
Phone (520) 719-4210

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

790 Remington Blvd
Bolingbrook, IL 60440

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

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

2122 York Rd
Ste 300
Oak Brook, IL 60523
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

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

6333 E Mockingbird Ln
Ste 139
Dallas, TX 75214
Phone (469) 782-7786

12747 Midway Rd
Ste 150
Dallas, TX 75244
Phone (469) 872-4562

6029 Forest Ln
Dallas, TX 75230
Phone (469) 872-7548

4015 Lemmon Ave
Dallas, TX 75219
Phone (469) 872-7461

9660 Audelia Rd
Ste 101
Dallas, TX 75238
Phone (214) 273-0510

14999 Preston Rd
Ste 108C
Dallas, TX 75254
Phone (214) 231-4154

308 Coit Rd
Ste 400
Plano, TX 75075
Phone (469) 573-9606

210 W Campbell Rd
Richardson, TX 75080
Phone (469) 709-4178

Interoperability endpoints

  • Direct secure messaging: jisha.varughese.p6@direct.athleticoltd.nextgenshare.com

Organizations & group practices 7

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": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1821795931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 W BASELINE RD STE 110",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853393097",
            "telephone_number": "602-830-9083",
            "fax_number": "602-281-7247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1065 E Tucson Marketplace Blvd Ste 155",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857136563",
            "country_code": "US",
            "telephone_number": "520-719-4210",
            "fax_number": "520-822-8641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "JISHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.