Individual provider Active NPI

Theodora Marie Dombkowski

  • Physical Therapist
  • Sunset Valley, TX
National Provider Identifier
1831766765
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5400 Brodie LN Ste 295
Sunset Valley, TX 78745-2525
Phone
(512) 676-3949
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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 Primary

Addresses

Primary practice location

5400 Brodie LN Ste 295
Sunset Valley, TX 78745-2525

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715000031 TX Practitioner - Physical Therapist in Private Practice 2860894755 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
Ideal Physical Therapy of Texas LLC 359 clinicians

Practice addresses (Care Compare)

5400 Brodie LN
Suite 295
Sunset Valley, TX 78745-2525
Phone (512) 676-3949

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
89.74
Improvement activities
40
Cost
61.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 21, 2021 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 21, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

1700 E Oltorf St
Ste 105
Austin, TX 78741
Phone (512) 652-0014

8900 S Congress Ave
Ste 400
Austin, TX 78745
Phone (210) 422-9203

10815 Ranch Road 2222
Unit 205
Austin, TX 78730
Phone (512) 975-7379

1245 Main St
Ste 230
Buda, TX 78610
Phone (512) 400-4437

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

2501 Ranch Road 620 S
Ste 140
Lakeway, TX 78738
Phone (512) 527-6944

1825 Crystal Falls Pkwy
Ste 150
Leander, TX 78641
Phone (512) 817-5001

5400 Brodie Ln
Ste 295
Sunset Valley, TX 78745
Phone (512) 676-3949

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": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1831766765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BRODIE LN STE 295",
            "city": "SUNSET VALLEY",
            "state": "TX",
            "postal_code": "787452525",
            "telephone_number": "512-676-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBKOWSKI",
        "first_name": "THEODORA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunset Valley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.