Individual provider Active NPI

Tracy Lynne Egelin, PT, DPT

  • Physical Therapist
  • Bartonville, TX
National Provider Identifier
1962736918
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1175586 Issued in TX
Practice address
3000 FM 407 Suite 500
Bartonville, TX 76226-7636
Phone
(940) 448-2007
Fax
(940) 448-2531
NPI assigned
Sep 23, 2009
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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 1175586 TX Primary

Addresses

Primary practice location

3000 FM 407 Suite 500
Bartonville, TX 76226-7636

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120001210 TX Practitioner - Physical Therapist in Private Practice 5092937300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4843 Colleyville Blvd
Suite 221
Colleyville, TX 76034-3986
Phone (817) 576-7520

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1175586TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Dec 1, 2017 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Dec 1, 2017 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

3000 FM 407 E
Ste 500
Bartonville, TX 76226
Phone (940) 448-2007

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

4843 Colleyville Blvd
Ste 221
Colleyville, TX 76034
Phone (817) 576-7520

5017 Teasley Ln
Ste 161
Denton, TX 76210
Phone (940) 220-2283

1050 Flower Mound Rd
Ste 140
Flower Mound, TX 75028
Phone (469) 702-5947

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

1288 W Main St
Ste 148
Lewisville, TX 75067
Phone (469) 496-3992

245 W State Highway 114
Ste 320
Southlake, TX 76092
Phone (817) 873-5311

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": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1962736918",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 FM 407 SUITE 500",
            "city": "BARTONVILLE",
            "state": "TX",
            "postal_code": "762267636",
            "telephone_number": "940-448-2007",
            "fax_number": "940-448-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGELIN",
        "first_name": "TRACY",
        "middle_name": "LYNNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1175586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartonville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.