Active NPI
Carlene Mary McCambridge, P.T., DPT
- Physical Therapist
- Boca Raton, FL
National Provider Identifier
1063629178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 301 Camino Gardens Blvd
Suite 104
Boca Raton, FL 33432 - Phone
- (561) 494-4499
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4071 | FL | |
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
301 Camino Gardens Blvd
Suite 104
Boca Raton, FL 33432
Mailing address
1831 SW Palm City Road
C301
Stuart, FL 34994
Phone (772) 777-0391
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 880791400 | Medicaid | FL | |
| 204299899 | Other | FEDERAL EMPLOYER ID |
Other names 1
- Carlene Mary Roach
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4071 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hope Home Therapy, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Tampa, FL
- NPI 1427244078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1063629178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1831 SW PALM CITY ROAD",
"address_2": "C301",
"city": "STUART",
"state": "FL",
"postal_code": "34994",
"telephone_number": "772-777-0391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 CAMINO GARDENS BLVD",
"address_2": "SUITE 104",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33432",
"telephone_number": "561-494-4499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCAMBRIDGE",
"first_name": "CARLENE",
"middle_name": "MARY",
"credential": "P.T., DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2021-06-25",
"certification_date": "2021-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "4071",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "880791400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL EMPLOYER ID",
"identifier": "204299899",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CARLENE",
"last_name": "ROACH",
"middle_name": "MARY",
"credential": "P.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.