Active NPI
Patrick Roosta, MS, LAT, ATC
- Athletic Trainer
- Weston, FL
National Provider Identifier
1053769000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 4506
- Practice address
- 16300 Golf Club Rd
Apt 214
Weston, FL 33326-1659 - Phone
- (954) 907-4882
- NPI assigned
- Jun 1, 2016
- Last updated
- Jun 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL 4506 | FL | Primary |
Addresses
Primary practice location
16300 Golf Club Rd
Apt 214
Weston, FL 33326-1659
Mailing address
16300 Golf Club Rd
Apt 214
Weston, FL 33326-1659
Phone (954) 907-4882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL 4506 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464739200000",
"number": "1053769000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16300 GOLF CLUB RD",
"address_2": "APT 214",
"city": "WESTON",
"state": "FL",
"postal_code": "333261659",
"telephone_number": "954-907-4882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16300 GOLF CLUB RD",
"address_2": "APT 214",
"city": "WESTON",
"state": "FL",
"postal_code": "333261659",
"telephone_number": "954-907-4882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSTA",
"first_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-01",
"last_updated": "2016-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 4506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.