Individual provider Active NPI

Michael Mesina, PT

  • Physical Therapist
  • South Elgin, IL
National Provider Identifier
1992066047
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-011624 Issued in IL
Practice address
759 Kane St
South Elgin, IL 60177-1418
Phone
(847) 697-3310
NPI assigned
Jun 5, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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 070-011624 IL Primary

Addresses

Primary practice location

759 Kane St
South Elgin, IL 60177-1418

Mailing address

759 Kane St
South Elgin, IL 60177-1418
Phone (847) 697-3310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070-011624ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1992066047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 KANE ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771418",
            "telephone_number": "847-697-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 KANE ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771418",
            "telephone_number": "847-697-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESINA",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-011624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.