Individual provider Active NPI

Roman Gressel, DPT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1104172923
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28078 Issued in FL
Practice address
5050 S Florida Ave
Lakeland, FL 33813-2501
Phone
(863) 688-3030
NPI assigned
Jul 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 035213-1 NY
Physical Therapist 225100000X 28078 FL Primary

Addresses

Primary practice location

5050 S Florida Ave
Lakeland, FL 33813-2501

Mailing address

5050 S Florida Ave
Lakeland, FL 33813-2501
Phone (863) 688-3030

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
28078FLMDPhysical Therapist
035213-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Touch Medical Care, P.C. PastSince Aug 13, 1996 Accepting new patients
Tampa Bay Spine and Injury Physical Therapist PastSince Feb 1, 2018 Accepting new patients
East Shore Medical PC Past Accepting new patients

Organizations & group practices 3

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1104172923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132501",
            "telephone_number": "863-688-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132501",
            "telephone_number": "863-688-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESSEL",
        "first_name": "ROMAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "035213-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "28078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.