Individual provider Active NPI

Ronald Joseph Brissette

  • Physical Therapy Assistant
  • Celebration, FL
National Provider Identifier
1013783703
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA32399 Issued in FL
Practice address
2954 Mallory Cir Ste 110
Celebration, FL 34747-1822
Phone
(321) 939-0222
NPI assigned
Dec 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA32399 FL Primary

Addresses

Primary practice location

2954 Mallory Cir Ste 110
Celebration, FL 34747-1822

Mailing address

12570 Splendid PL Apt 1309
Orlando, FL 32821-0023
Phone (716) 598-3833

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
PTA32399FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Celebration Orthopedic and Sports Medicine Institute Inc PastSince Dec 10, 2023 Accepting new patients
Celebration Orthopedic and Sports Medicine Institute Inc PastSince Dec 10, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1013783703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12570 SPLENDID PL APT 1309",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328210023",
            "telephone_number": "716-598-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2954 MALLORY CIR STE 110",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347471822",
            "telephone_number": "321-939-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISSETTE",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.