Individual provider Active NPI

William Fabian, PT, DPT

  • Physical Therapist
  • Winter Haven, FL
National Provider Identifier
1023720877
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39769
Practice address
1601 6TH St SE
Winter Haven, FL 33880-4605
Phone
(863) 294-0350
Fax
(863) 294-0381
NPI assigned
Dec 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 PT39769 Primary

Addresses

Primary practice location

1601 6TH St SE
Winter Haven, FL 33880-4605

Mailing address

1601 6TH St SE Ste B
Winter Haven, FL 33880-4605
Phone (863) 294-0350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260526001779 FL Practitioner - Physical Therapist in Private Practice 5890265367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

234 Mall Blvd
Suite G50
King of Prussia, PA 19406-2921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cora Health Services, Inc PastSince Dec 28, 2022 Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1023720877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 6TH ST SE STE B",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804605",
            "telephone_number": "863-294-0350",
            "fax_number": "863-294-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 6TH ST SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804605",
            "telephone_number": "863-294-0350",
            "fax_number": "863-294-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "WILLIAM",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-22",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "PT39769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.