Individual provider Active NPI

Jeanine Barraza, DPT

  • Physical Therapist
  • Fort Lauderdale, FL
National Provider Identifier
1083981047
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26962 Issued in FL
Practice address
2853 Hidden Harbour CT
Ft Lauderdale, FL 33312-3570
Phone
(305) 510-0378
Fax
(954) 744-4024
NPI assigned
Nov 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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 PT26962 FL Primary

Addresses

Primary practice location

2853 Hidden Harbour CT
Ft Lauderdale, FL 33312-3570

Mailing address

2853 Hidden Harbour CT
Ft Lauderdale, FL 33312-3570
Phone (305) 510-0378

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

LicenseStateTypeSpecialty
PT26962FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1083981047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 HIDDEN HARBOUR CT",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333123570",
            "telephone_number": "305-510-0378",
            "fax_number": "954-744-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 HIDDEN HARBOUR CT",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333123570",
            "telephone_number": "305-510-0378",
            "fax_number": "954-744-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAZA",
        "first_name": "JEANINE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.