Individual provider Active NPI

Autumn Neuharth, PT

  • Physical Therapist
  • Oak Park, IL
National Provider Identifier
1841737129
Registry record updated Jul 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070023613 Issued in IL
Practice address
1049 Lake St Ste 201
Oak Park, IL 60301
Phone
(877) 709-1090
Fax
(866) 221-3400
NPI assigned
Jan 25, 2017
Last updated
Jul 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2018

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 070023613 IL Primary

Addresses

Primary practice location

1049 Lake St Ste 201
Oak Park, IL 60301

Mailing address

211 N Clinton St Ste 2N
Chicago, IL 60661-1283
Phone (877) 709-1090

Other practice location 1

505 62nd St
Apt 6D
Brooklyn, NY 11220-4639
Phone (718) 369-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180813000015 IL Practitioner - Physical Therapist in Private Practice 8325321870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 W Roosevelt Rd
Mc727
Chicago, IL 60608-1316
Phone (312) 413-1871

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jun 1, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
University of Illinois Speech and Hearing CurrentSince Jun 1, 2024 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1640 W Roosevelt Rd
#727
Chicago, IL 60608
Phone (312) 413-1871

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1841737129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N CLINTON ST STE 2N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611283",
            "telephone_number": "877-709-1090",
            "fax_number": "866-221-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 LAKE ST STE 201",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "60301",
            "telephone_number": "877-709-1090",
            "fax_number": "866-221-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 62nd St",
            "address_2": "Apt 6D",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112204639",
            "country_code": "US",
            "telephone_number": "718-369-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEUHARTH",
        "first_name": "AUTUMN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2018; 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.