Individual provider Active NPI

Rebecca Anne Paulin-Liston, P.T.

  • Orthopedic Physical Therapist
  • Evanston, IL
National Provider Identifier
1851615504
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
070.010434 Issued in IL
Practice address
1729 Benson Ave
Evanston, IL 60201-3704
Phone
(847) 570-7170
Fax
(847) 570-7172
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 070.010434 IL Primary

Addresses

Primary practice location

1729 Benson Ave
Evanston, IL 60201-3704

Mailing address

1729 Benson Ave
Evanston, IL 60201-3704
Phone (847) 570-7170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302003122 IL Practitioner - Physical Therapist in Private Practice 3375959190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1609 Sherman Ave
Suite 308
Evanston, IL 60201-5013
Phone (224) 935-3081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.010434ILMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Physical Therapy and Yoga LLC Orthopedic CurrentSince Oct 16, 2020 Accepting new patients

Locations

1609 Sherman Ave
Ste 308
Evanston, IL 60201
Phone (224) 935-3081

Organizations & group practices 1

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": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1851615504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 BENSON AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013704",
            "telephone_number": "847-570-7170",
            "fax_number": "847-570-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 BENSON AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013704",
            "telephone_number": "847-570-7170",
            "fax_number": "847-570-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULIN-LISTON",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "IL",
            "license": "070.010434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.