Douglas Joseph Meyrose, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013795 Issued in IL

Practice address

1629 Chicago Ave
Evanston, IL 60201-4504

Phone

(847) 475-1630

Fax

(847) 475-1631

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foothills Sports Medicine and Rehabilitation LLCGroup PAC ID 2668457979, 172 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1558318170
  Medicare reassignment Care Compare group NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1073224267
  NPD
• Vanness Chiropractic SC

  • Chiropractor
  • Barrington, IL
  • NPI 1386860260
  NPD (past)
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Tucson, AZ
  • NPI 1699405050
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1982613519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014504",
            "telephone_number": "847-475-1630",
            "fax_number": "847-475-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYROSE",
        "first_name": "DOUGLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Elise Meyer
• Michael Meyer, DMD
• Kim Charles Meyers, M.D.
• Stephen Christine Meyers, LCPC
• Lisa Meyerson, L.AC.
• Kristy Ranae Meza
• MHP Counseling PLLC
• Michael a Conforti LCSW Inc
• Michael England, Psy.D., P.C.
• Michael J Verta Jr, MDSC

• Physical Therapist in Evanston, IL
• Providers in Evanston, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; 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.