Individual provider Active NPI

Bryan M Stednitz, PT

  • Physical Therapist
  • Winfield, IL
National Provider Identifier
1952741571
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
0S050 Winfield Rd
Suite 120
Winfield, IL 60190-1227
Phone
(630) 653-4743
Fax
(630) 653-4912
NPI assigned
Jun 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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 Primary

Addresses

Primary practice location

0S050 Winfield Rd
Suite 120
Winfield, IL 60190-1227

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818000928 ID Practitioner - Physical Therapist in Private Practice 3678708120 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy 180 LLCGroup PAC ID 9830422955, 3 clinicians

Practice addresses (Care Compare)

5909 W State St
Boise, ID 83703-3039
Phone (208) 343-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sawtooth Physical Therapy CurrentSince Aug 17, 2020 Accepting new patients
Sawtooth Physical Therapy Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Physical Therapy 180 LLC Physical Therapist CurrentSince Apr 14, 2024 Accepting new patients
CSRM LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
CSRM LLC CurrentSince Jan 1, 2022 Accepting new patients
Athletic and Therapeutic Institute of Naperville, LLC Physical Therapist Past Accepting new patients
Peregrine Physical Therapy LLC Physical Therapist PastSince Apr 14, 2024 Accepting new patients

Locations

5909 W State St
Boise, ID 83703
Phone (208) 343-7700

7979 W Rifleman St
Ste 100
Boise, ID 83704
Phone (208) 375-6133

7979 W Rifleman St
Ste 200
Boise, ID 83704
Phone (208) 377-3850

3015 E Magic View Dr
Ste 100
Meridian, ID 83642
Phone (208) 887-3498

4842 N Cortona Way
Ste 100
Meridian, ID 83646
Phone (208) 888-8302

16816 N Marketplace Blvd
Nampa, ID 83687
Phone (208) 461-9593

Organizations & group practices 7

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1952741571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0S050 WINFIELD RD",
            "address_2": "SUITE 120",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901227",
            "telephone_number": "630-653-4743",
            "fax_number": "630-653-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEDNITZ",
        "first_name": "BRYAN",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; 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.