Individual provider Active NPI

Bassill Itani, DPT

  • Physical Therapist
  • Kissimmee, FL
National Provider Identifier
1083273783
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3350 W Southport Rd
Kissimmee, FL 34746-2706
Phone
(407) 846-0152
NPI assigned
Jun 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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 Primary

Addresses

Primary practice location

3350 W Southport Rd
Kissimmee, FL 34746-2706

Mailing address

13006 Heming Way
Orlando, FL 32825-2712
Phone (407) 963-0922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723000223 FL Practitioner - Physical Therapist in Private Practice 4789087131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
86.58
Improvement activities
40
Cost
68.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 29, 2023 Accepting new patients
Cora Health Services, Inc Past Accepting new patients
Physiotherapy Works LLC Physical Therapist PastSince Jun 30, 2021 Accepting new patients
Cora Health Services Inc Past Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

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": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1083273783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13006 HEMING WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328252712",
            "telephone_number": "407-963-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W SOUTHPORT RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462706",
            "telephone_number": "407-846-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITANI",
        "first_name": "BASSILL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.