Individual provider Active NPI

Poorvi D Ajmera

  • Occupational Therapist
  • Long Grove, IL
National Provider Identifier
1922280478
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056016561 Issued in IL
Practice address
1190 Old McHenry Rd
Long Grove, IL 60047-5088
Phone
(847) 713-1203
NPI assigned
Nov 27, 2007
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056016561 IL Primary

Addresses

Primary practice location

1190 Old McHenry Rd
Long Grove, IL 60047-5088

Mailing address

1353 Maidstone Dr
Vernon Hills, IL 60061-1089
Phone (412) 310-0760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251016002894 IL Practitioner - Occupational Therapist in Private Practice 2264929850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians

Practice addresses (Care Compare)

1190 Old McHenry Rd
Long Grove, IL 60047-5088
Phone (224) 576-2183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Senior Living LLC Occupational Therapist CurrentSince Sep 15, 2025 Accepting new patients
Reliant Senior Living LLC Occupational Therapist CurrentSince Sep 15, 2025 Accepting new patients

Locations

1190 Old McHenry Rd
Long Grove, IL 60047
Phone (224) 576-2183

5800 Granite Pkwy
Ste 325
Plano, TX 75024

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, 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": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1922280478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 MAIDSTONE DR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611089",
            "telephone_number": "412-310-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 OLD MCHENRY RD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475088",
            "telephone_number": "847-713-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJMERA",
        "first_name": "POORVI",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056016561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.