Stephen Landreville, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

21687 Issued in FL

Practice address

3066 SW Martin Downs Blvd
Palm City, FL 34990-2683

Phone

(954) 994-9908

NPI assigned

Nov 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare Institute LLCGroup PAC ID 2365626272, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sportscare Institute, LLC

  • Physical Therapist
  • Winter Park, FL
  • NPI 1336466671
  Medicare reassignment Care Compare group NPD
• Gait Mechanics, Inc

  • Physical Therapy Clinic/Center
  • Lake Worth, FL
  • NPI 1497199657
  Medicare reassignment NPD
• Scott Physical Therapy P.C.

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1841270923
  NPD (past)
• Stride Therapy Solutions Inc

  • Home Health Agency
  • Roswell, GA
  • NPI 1023727310
  NPD (past)

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1033710769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7233 NW 116TH WAY",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330763356",
            "telephone_number": "954-994-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 SW MARTIN DOWNS BLVD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902683",
            "telephone_number": "954-994-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDREVILLE",
        "first_name": "STEPHEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "21687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "21687",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "address_1": "3066 SW Martin Downs Blvd",
            "city": "Palm City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349902683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candice Labounty
• Heather Lacharite, MS,BCBA
• Christina Ladd
• Chanice Lake, M.ED, NCC
• Willmer Landaeta
• Marylou Irwin Lang
• Justin Lanzetta
• Susan Lauderdale, LMFT
• Megan Laviano
• Rochelle Lawrence

• Physical Medicine & Rehabilitation Physician in Palm City, FL
• Providers in Palm City, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.