Individual provider Active NPI

Joshua Fede, DPT

  • Sports Physical Therapist
  • Sunrise, FL
National Provider Identifier
1093109852
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
30161 Issued in FL
Practice address
2035 N University Dr
Sunrise, FL 33322-3936
Phone
(954) 616-1670
NPI assigned
Mar 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 30161 FL Primary
Orthopedic Physical Therapist 2251X0800X 30161 FL

Addresses

Primary practice location

2035 N University Dr
Sunrise, FL 33322-3936

Mailing address

4311 NW 53Rd CT
Coconut Creek, FL 33073-4007
Phone (786) 683-9226

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151119000040 FL Practitioner - Physical Therapist in Private Practice 1254631534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3450 NW 62ND Ave
Margate, FL 33063-8311
Phone (786) 683-9226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30161FLMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fede Sports and Physical Therapy LLC Sports CurrentSince Dec 8, 2024 Accepting new patients

Locations

3450 NW 62nd Ave
Margate, FL 33063
Phone (786) 683-9226

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.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1093109852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 NW 53RD CT",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734007",
            "telephone_number": "786-683-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 N UNIVERSITY DR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333223936",
            "telephone_number": "954-616-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDE",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-19",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "30161",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "30161",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.