Moose Physical Therapy, PLLC
NPI 1053927640ActiveOrganization· Physical Therapist· Peoria, IL
Physical Therapist in Peoria, Illinois, registered in NPPES in September 2020. The authorized official on file is Jeremy Calame, PT, DPT, Managing Member. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1053927640 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 18, 2020 |
| Last updated in NPPES | Oct 31, 2021 |
| Certified by provider | Oct 31, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (IL) |
|---|
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