Individual provider Active NPI

Amol Bakre

  • Physical Therapist
  • Belle Glade, FL
National Provider Identifier
1033575238
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT31001 Issued in FL
Practice address
1100 S Main St # 103
Belle Glade, FL 33430-4910
Phone
(561) 762-6866
Fax
(561) 624-1192
NPI assigned
Jan 5, 2016
Last updated
Jan 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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 PT31001 FL Primary

Addresses

Primary practice location

1100 S Main St # 103
Belle Glade, FL 33430-4910

Mailing address

1100 S Main St # 103
Belle Glade, FL 33430-4910
Phone (561) 762-6866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170103001484 MD Practitioner - Physical Therapist in Private Practice 8325344930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT31001FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Physical Therapy, LLC Physical Therapist Current Accepting new patients
Civista Medical Center, Inc. CurrentSince Nov 2, 2016 Accepting new patients
Civista Medical Center Inc CurrentSince Nov 2, 2016 Accepting new patients

Locations

1100 S Main St
Ste 103
Belle Glade, FL 33430
Phone (561) 996-7032

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

106 Ponce de Leon St
Royal Palm Beach, FL 33411
Phone (561) 236-3741

701 Charles St
La Plata, MD 20646
Phone (301) 609-4000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1033575238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST # 103",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910",
            "telephone_number": "561-762-6866",
            "fax_number": "561-624-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S MAIN ST # 103",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334304910",
            "telephone_number": "561-762-6866",
            "fax_number": "561-624-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKRE",
        "first_name": "AMOL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Glade, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.