Individual provider Active NPI

Jason Lee Robinson, P.T.

  • Physical Therapist
  • Sandwich, IL
National Provider Identifier
1902911076
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-010389 Issued in IL
Practice address
710 E Railroad St
Sandwich, IL 60548
Phone
(815) 313-6333
Fax
(815) 417-6921
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 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 070-010389 IL Primary

Addresses

Primary practice location

710 E Railroad St
Sandwich, IL 60548

Mailing address

710 E Railroad St
Sandwich, IL 60548-2250
Phone (815) 313-6333

Other practice location 1

1310 N Main St Ste 100
Sandwich, IL 60548-1394
Phone (815) 786-6000

Other practice location 2

101 S Main St
Sandwich, IL 60548-2172
Phone (815) 786-9291 ext. 2

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000630 IL Practitioner - Physical Therapist in Private Practice 1456370790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Catalyst Physiotherapy, Performance, and Wellness LLCGroup PAC ID 0042591000, 2 clinicians

Practice addresses (Care Compare)

710 E Railroad St
Suite B
Sandwich, IL 60548-2606
Phone (815) 793-7550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070-010389ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst Physiotherapy, Performance, & Wellness LLC Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Wylde Physical Therapy, LLC PastSince Apr 26, 2017 Accepting new patients

Locations

103 E Wilson St
Batavia, IL 60510
Phone (815) 313-6333

101 S Main St
Sandwich, IL 60548
Phone 8157869291 ext. 2

710 E Railroad St
Sandwich, IL 60548
Phone (815) 313-6333

710 E Railroad St
Ste B
Sandwich, IL 60548
Phone (815) 313-6333

Organizations & group practices 2

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1902911076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E RAILROAD ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482250",
            "telephone_number": "815-313-6333",
            "fax_number": "815-417-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E RAILROAD ST",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "60548",
            "telephone_number": "815-313-6333",
            "fax_number": "815-417-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 N Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "IL",
            "postal_code": "605481394",
            "country_code": "US",
            "telephone_number": "815-786-6000",
            "fax_number": "815-570-2275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 S Main St",
            "address_purpose": "LOCATION",
            "city": "Sandwich",
            "state": "IL",
            "postal_code": "605482172",
            "country_code": "US",
            "telephone_number": "815-786-9291 x2",
            "fax_number": "815-417-6921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JASON",
        "middle_name": "LEE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-010389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandwich, IL

Sources for this page

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