Active NPI
Shafali Hegde
- Physical Therapist
- Naperville, IL
National Provider Identifier
1932732583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.012780
- Practice address
- 720 Raymond Dr
Naperville, IL 60563-9758 - Phone
- (630) 355-0220
- NPI assigned
- Feb 21, 2020
- Last updated
- Apr 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.012780 | IL | Primary |
Addresses
Primary practice location
720 Raymond Dr
Naperville, IL 60563-9758
Mailing address
11514 Century Cir
Plainfield, IL 60585-7101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12446 S Van Dyke Rd
Plainfield, IL 60585-2700
Phone (815) 216-4042
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.012780 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paxxon Healthcare Services LLC | Physical Therapist | Current | Accepting new patients |
| Paxxon Healthcare Services LLC | Physical Therapist | Current | Accepting new patients |
Locations
1619 N Mill St
Naperville, IL 60563
Phone (630) 701-6040
Organizations & group practices 3
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.
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- NPI 1336808146
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1932732583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11514 CENTURY CIR",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605857101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 RAYMOND DR",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605639758",
"telephone_number": "630-355-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEGDE",
"first_name": "SHAFALI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.012780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.