Patricia Martin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-006253 Issued in IL

Practice address

520 E Boughton Rd
Bolingbrook, IL 60440-2181

Phone

(630) 783-2438

Fax

(630) 739-2589

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Group practices

Advanced Wellness Medical LLCGroup PAC ID 6800113887, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Wellness Medical, LLC

  • General Practice Physician
  • Woodridge, IL
  • NPI 1831597194
  Medicare reassignment Care Compare group NPD
• Accelerated Rehabilitation Centers LTD

  • Physical Therapist
  • Westmont, IL
  • NPI 1205875713
  NPD (past)
• Accelerated Rehabilitation Centers, LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Roscoe, IL
  • NPI 1043604184
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1841335056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402181",
            "telephone_number": "630-783-2438",
            "fax_number": "630-739-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PATRICIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-006253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11775364",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275738221",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000535153",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007714984",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "089937",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PYRAMID TODAYS OPTIONS",
            "identifier": "260374180100",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICECARE NETWORK",
            "identifier": "260374180",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHN",
            "identifier": "38856",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Ann Marasco, COTA
• Marcia S. Gibson, Psy.D and Associates, P. C..
• Maria Goldstein, PC
• Maria Medical LLC
• Maria Nida V. Barino MD LTD
• Ana Martinez-Ruiz, LMT
• Mary Grimwood & Assoc LTD (Dr. Mary M. Grimwood & Associates)
• Lindsay Elizabeth Maskel, FNP
• Kimberly Lynn Mason, RSA
• Cheryl Mathew, BCBA

• Physical Therapist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.