Individual provider Active NPI

Betty Carreno, PT

  • Physical Therapist
  • Chicago, IL
National Provider Identifier
1831251073
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070010042 Issued in IL
Practice address
1505 W Devon
Chicago, IL 60660
Phone
(773) 316-5305
Fax
(773) 743-4881
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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 070010042 IL Primary

Addresses

Primary practice location

1505 W Devon
Chicago, IL 60660

Mailing address

6039 N Mozart
Chicago, IL 60659
Phone (773) 316-5305

Other identifiers 2

IdentifierTypeStateIssuer
300084121OtherILTAX ID
1285635532OtherILORGANIZATION NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119000293 IL Practitioner - Physical Therapist in Private Practice 3971417288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4733 N Damen Ave
Chicago, IL 60625-1442
Phone (773) 316-5305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070010042ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Plus PC Physical Therapist CurrentSince Jun 19, 2002 Accepting new patients
Americare Health & Rehab Centetr PC PastSince May 2, 2012 Accepting new patients
Hispanic Regional Clinics SC Past Accepting new patients

Locations

1505 W Devon Ave
Chicago, IL 60660
Phone (773) 316-5305

4733 N Damen Ave
Chicago, IL 60625
Phone (773) 871-2250

Organizations & group practices 3

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1831251073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6039 N MOZART",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-316-5305",
            "fax_number": "773-743-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W DEVON",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60660",
            "telephone_number": "773-316-5305",
            "fax_number": "773-743-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRENO",
        "first_name": "BETTY",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070010042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "300084121",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI",
            "identifier": "1285635532",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.