Individual provider Active NPI

Desiree Cougill

  • Physical Therapist
  • Providence, RI
National Provider Identifier
1891675906
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.025266 Issued in IL
Practice address
401 Elmgrove Ave
Providence, RI 02906-3451
Phone
(401) 421-4111
NPI assigned
Sep 8, 2025
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 070.025266 IL Primary

Addresses

Primary practice location

401 Elmgrove Ave
Providence, RI 02906-3451

Mailing address

2970 N Sheridan Rd Apt 1406
Chicago, IL 60657-5831

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002000925 RI Practitioner - Physical Therapist in Private Practice 0840796413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay State Physical Therapy PCGroup PAC ID 6305176850, 37 clinicians

Practice addresses (Care Compare)

401 Elmgrove Ave
Providence, RI 02906-3451
Phone (401) 490-9780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.025266ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay State Physical Therapy PC Physical Therapist CurrentSince Sep 24, 2025 Accepting new patients

Locations

703 Granite St
Ste 300
Braintree, MA 02184
Phone (603) 626-4205

235 Plain St
Ste 307
Providence, RI 02905
Phone (401) 414-4601

401 Elmgrove Ave
Providence, RI 02906
Phone (401) 421-4111

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, 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": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1891675906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 N SHERIDAN RD APT 1406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ELMGROVE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063451",
            "telephone_number": "401-421-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGILL",
        "first_name": "DESIREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.025266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.