NPIMap

Organization Active NPI

Evolution Rehab Group LLC

  • Physical Therapist
  • Jupiter, FL
National Provider Identifier
1023840246
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVOLUTION REHAB GROUP LLC
Practice address
350 Bush Rd
Jupiter, FL 33458-5694
Phone
(561) 900-2423
Fax
(561) 600-3011
NPI assigned
Aug 16, 2024
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
Dr. Benjamin Marc Galin, DPTNPI 1740458215
Title
Administrator
Phone
(561) 900-2423

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

350 Bush Rd
Jupiter, FL 33458-5694

Mailing address

7950 Dani Dr # 140-2
Fort Myers, FL 33966-8012
Phone (561) 900-2423

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241018003867 FL Part B Supplier - Clinic/Group Practice 9032546163 Receives reassigned benefits from 21 practitioners
Practice locations: Fort Myers, FL; Jupiter, FL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

7950 Dani Dr
#1402
Fort Myers, FL 33966
Phone (561) 900-2423

350 Bush Rd
Ofc
Jupiter, FL 33458
Phone (561) 900-2423

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1023840246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 DANI DR # 140-2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339668012",
            "telephone_number": "561-900-2423",
            "fax_number": "561-600-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BUSH RD",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585694",
            "telephone_number": "561-900-2423",
            "fax_number": "561-600-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION REHAB GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "GALIN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "561-900-2423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.