Individual provider Active NPI

Yvelise Petit Stanley, PT

  • Geriatric Physical Therapist
  • Davie, FL
National Provider Identifier
1093963951
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
PT4711 Issued in FL
Practice address
5741 SW 109TH Ave
Davie, FL 33328-6303
Phone
(954) 261-5625
Fax
(954) 434-7385
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4711 FL
Geriatric Physical Therapist 2251G0304X PT4711 FL Primary
Neurology Physical Therapist 2251N0400X PT4711 FL
Orthopedic Physical Therapist 2251X0800X PT4711 FL

Addresses

Primary practice location

5741 SW 109TH Ave
Davie, FL 33328-6303

Mailing address

5741 SW 109TH Ave
Davie, FL 33328-6303
Phone (954) 261-5625

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090311000728 FL Practitioner - Physical Therapist in Private Practice 4981760253 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

State licenses

LicenseStateTypeSpecialty
PT4711FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 7, 2022 Accepting new patients

Locations

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

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1093963951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5741 SW 109TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333286303",
            "telephone_number": "954-261-5625",
            "fax_number": "954-434-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5741 SW 109TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333286303",
            "telephone_number": "954-261-5625",
            "fax_number": "954-434-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "YVELISE",
        "middle_name": "PETIT",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT4711",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT4711",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "FL",
            "license": "PT4711",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT4711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.