Active NPI
Carissa D Aquino, DPT
- Physical Therapist
- Fleming Island, FL
National Provider Identifier
1063995306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT39040
- Practice address
- 1747 Baptist Clay Dr Ste 210
Fleming Island, FL 32003-8505 - Phone
- (904) 621-0396
- Fax
- (904) 621-0397
- NPI assigned
- Sep 12, 2018
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL4644 | FL | |
| Physical Therapist | 225100000X | PT39040 | FL | Primary |
Addresses
Primary practice location
1747 Baptist Clay Dr Ste 210
Fleming Island, FL 32003-8505
Mailing address
PO Box 117345
Atlanta, GA 30368-7345
Phone (904) 346-3465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221004002778 | FL | Practitioner - Physical Therapist in Private Practice | 3870979503 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.26 of 100
- Quality
- 86.58
- Improvement activities
- 40
- Cost
- 68.79
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.01 of 100
- Improvement activities
- 40
- Cost
- 74.03
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT39040 | FL | MD | Physical Therapist |
| AL4644 | FL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacksonville Orthopaedic Institute Inc | Physical Therapist | Past | Accepting new patients |
| Jacksonville Orthopaedic Institute Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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
- Fleming Island, FL
- NPI 1285961763
-
- Physical Therapist
- Fernandina Beach, FL
- NPI 1942660212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678838400000",
"number": "1063995306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 117345",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303687345",
"telephone_number": "904-346-3465",
"fax_number": "904-858-6489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1747 BAPTIST CLAY DR STE 210",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320038505",
"telephone_number": "904-621-0396",
"fax_number": "904-621-0397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "CARISSA",
"middle_name": "D",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-12",
"last_updated": "2023-03-15",
"certification_date": "2023-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL4644",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT39040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fleming Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.