Individual provider Active NPI

Lee Duane Jacobson, P.T.

  • Physical Therapist
  • Dunnellon, FL
National Provider Identifier
1063418952
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11360 Issued in FL
Practice address
20726 W Pennsylvania Ave
Dunnellon, FL 34431-6717
Phone
(352) 465-5880
Fax
(352) 465-5889
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PT11360 FL Primary

Addresses

Primary practice location

20726 W Pennsylvania Ave
Dunnellon, FL 34431-6717

Mailing address

8455 S Suncoast Blvd
Homosassa, FL 34446-5066
Phone (352) 465-5880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000342 FL Practitioner - Physical Therapist in Private Practice 3971774779 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles (5 of 7)

OrganizationSpecialtyStatusNew patients
TLC Rehab, LLC Physical Therapist Past Accepting new patients
TLC Rehab, LLC Physical Therapist PastSince Sep 8, 2019 Accepting new patients
Lco Group, PA PastSince Jun 11, 2018 Accepting new patients
TLC Rehab, LLC Physical Therapist Past Accepting new patients
TLC Rehab, LLC Physical Therapist Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063418952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344465066",
            "telephone_number": "352-465-5880",
            "fax_number": "352-465-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20726 W PENNSYLVANIA AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344316717",
            "telephone_number": "352-465-5880",
            "fax_number": "352-465-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "LEE",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT11360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunnellon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.