NPIMap

Organization Active NPI

Atlantic Rehabilitation Center

  • Rehabilitation Practitioner
  • Davie, FL
National Provider Identifier
1003973967
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
22768 Issued in FL
Legal business name
ATLANTIC REHABILITATION CENTER
Practice address
11870 W State Road 84 Ste C3
Davie, FL 33325-3811
Phone
(954) 474-3611
Fax
(954) 474-3613
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Joseph CaroccioNPI 1902963895
Title
Owner, MPT
Phone
(305) 405-0400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X 22768 FL Primary

Addresses

Primary practice location

11870 W State Road 84 Ste C3
Davie, FL 33325-3811

Mailing address

16249 Biscayne Blvd
Aventura, FL 33160-4300
Phone (305) 405-0400

Other identifiers 1

IdentifierTypeStateIssuer
Y918TOtherFLBLUE CROSS BLUE SHEILD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110812000452 FL Part B Supplier - Clinic/Group Practice 8527237247 Receives reassigned benefits from 23 practitioners
2 other NPIs on this enrollment
Practice locations: Aventura, FL; Davie, FL; Pembroke Pines, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Rehab Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16249 Biscayne Blvd
Aventura, FL 33160
Phone (305) 405-0400

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1003973967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16249 BISCAYNE BLVD",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331604300",
            "telephone_number": "305-405-0400",
            "fax_number": "305-405-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11870 W STATE ROAD 84 STE C3",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333253811",
            "telephone_number": "954-474-3611",
            "fax_number": "954-474-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "CAROCCIO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER, MPT",
        "authorized_official_telephone_number": "305-405-0400"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "FL",
            "license": "22768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "Y918T",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.