CUSTOM CARE REHAB, LLC
NPI 1619598778
Physical Therapist in Peninsula, OH

Active since April 29, 2020
4175 BELLAIRE LN, PENINSULA, OH 44264(330) 618-5703 Get Directions Write a Review

NPPES record last updated: June 20, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Custom Care Rehab, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CUSTOM CARE REHAB, LLC (NPI 1619598778) is a healthcare organization registered as a physical therapist in Peninsula, Ohio and active in the NPI registry since April 2020. The organization lists Amy Mcmillin, Owner/ Physical Therapist, as its authorized official.

NPPES Registry Identity

NPI1619598778
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameCUSTOM CARE REHAB, LLC
Location Address4175 BELLAIRE LNPeninsula, OH 44264-9787
Mailing Address4175 Bellaire LnPeninsula, OH 44264-9787 · (330) 618-5703
Organization SubpartNo
Authorized OfficialAmy McmillinOwner/ Physical Therapist · (330) 618-5703
Enumeration DateApril 29, 2020
Last NPPES UpdateJune 20, 2020
NPPES CertifiedJune 20, 2020
✔ NPI 1619598778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
4175 BELLAIRE LN, Peninsula, OH 44264

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Custom Care Rehab, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Custom Care Rehab, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Physical Therapist in Private Practice
NPI 1881219780
4175 BELLAIRE LN
Peninsula, OH 44264
(234) 303-1311
✔ Accepts MedicareSame address
Physical Therapist in Private Practice
NPI 1346080967
3632 ALLARD RD
Medina, OH 44256
(716) 255-8465
9.4 mi
Physical Therapist in Private Practice
NPI 1851978639
7171 KECK PARK CIR NW
North Canton, OH 44720
(330) 498-8200
✔ Accepts Medicare23 mi
Physical Therapist in Private Practice
NPI 1669150074
14950 S SPRINGDALE AVE
Middlefield, OH 44062
(440) 993-1004
✔ Accepts Medicare29 mi
Physical Therapist in Private Practice
NPI 1215025564
7230 MENTOR AVE
Mentor, OH 44060
(440) 946-5858
✔ Accepts Medicare32 mi
Physical Therapist in Private Practice
NPI 1629798988
8836 TYLER BLVD
Mentor, OH 44060
(440) 255-9553
✔ Accepts Medicare35 mi
Physical Therapist in Private Practice
NPI 1417605627
805 PATRIOT DR
Wellington, OH 44090
(440) 647-0107
✔ Accepts Medicare37 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Custom Care Rehab, LLC's NPI number?

The NPI number for Custom Care Rehab, LLC is 1619598778. It was assigned to this organization in the NPPES registry on April 29, 2020.

Where is Custom Care Rehab, LLC located?

Custom Care Rehab, LLC is located at 4175 Bellaire Ln, Peninsula, OH 44264. The listed phone number is (330) 618-5703.

What is Custom Care Rehab, LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Custom Care Rehab, LLC enrolled in Medicare?

Yes. Custom Care Rehab, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Custom Care Rehab, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Custom Care Rehab, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Custom Care Rehab, LLC was last updated on June 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.