Individual provider Active NPI

Jean Marie Traitz

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1851178818
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-033576 Issued in AZ
Practice address
5803 W Northern Ave Ste 110
Glendale, AZ 85301-1362
Phone
(623) 295-3699
NPI assigned
Sep 13, 2023
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT40792 FL
Physical Therapist 225100000X LPT-033576 AZ Primary

Addresses

Primary practice location

5803 W Northern Ave Ste 110
Glendale, AZ 85301-1362

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

943 Pine Log Rd
Aiken, SC 29803-7330
Phone (803) 649-9797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240819003963 AZ Practitioner - Physical Therapist in Private Practice 0840647996 Reassigns benefits to 1 organization
I20260302001477 FL Practitioner - Physical Therapist in Private Practice 0840647996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Rehabilitation CenterGroup PAC ID 8527237247, 11 clinicians

Practice addresses (Care Compare)

17900 NW 5TH St
Suite 102
Pembroke Pines, FL 33029-2809
Phone (305) 405-0400

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-033576AZMDPhysical Therapist
PT40792FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Rehabilitation Center CurrentSince Jan 12, 2026 Accepting new patients
Atlantic Rehabilitation Center CurrentSince Jan 12, 2026 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Aug 19, 2024 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

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

5803 W Northern Ave
Ste 110
Glendale, AZ 85301
Phone (623) 295-3699

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

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

11870 Sr 84
Bldg C3
Davie, FL 33325
Phone (954) 474-3611

17900 NW 5th St
Ste 102
Pembroke Pines, FL 33029
Phone (954) 251-0733

790 Remington Blvd
Bolingbrook, IL 60440

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1851178818",
    "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",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 W NORTHERN AVE STE 110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011362",
            "telephone_number": "623-295-3699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 Pine Log Rd",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298037330",
            "country_code": "US",
            "telephone_number": "803-649-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAITZ",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40792",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-033576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.