Jennifer Ann Modzelewski, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA25476 Issued in FL

Practice address

4625 Bayshore Dr Apt D16
Naples, FL 34112-4360

Phone

(586) 524-3089

NPI assigned

Jan 26, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Jennifer Ann Couto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1033415807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "978 GIBRALTAR RD",
            "address_2": "UNIT 2",
            "city": "KEY LARGO",
            "state": "FL",
            "postal_code": "330374609",
            "telephone_number": "586-524-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 BAYSHORE DR APT D16",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341124360",
            "telephone_number": "586-524-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODZELEWSKI",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002091",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA25476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "COUTO",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mobile Foot Doc LLC
• Mobile Medical Imaging LLC
• Mobile Rehab & Lymphatics LLC
• Mobile Rehab LLC
• Jennifer Modzelesky, M.S., BCBA
• Molly Modzelewski, LMHC
• Sein Moe, DDS
• Alexander John Moga, LPCC/LMHC
• Rebecca Jean Mogensen-Kruger, ARNP
• Naghmeh Mohajeran

• Physical Therapy Assistant in Naples, FL
• Providers in Naples, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.