Individual provider Active NPI

Logan Alexander Arena, PT, DPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1104371608
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4539 S Dale Mabry Hwy
Suite 110
Tampa, FL 33611-1404
Phone
(813) 250-1208
NPI assigned
Aug 25, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 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

4539 S Dale Mabry Hwy
Suite 110
Tampa, FL 33611-1404

Mailing address

1677 Atlanta Plaza Dr
Sanibel, FL 33957-4327
Phone (508) 868-7179

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161112000005 FL Practitioner - Physical Therapist in Private Practice 3678852753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Florida College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Foot and Leg Center PAGroup PAC ID 3678506326, 16 clinicians

Practice addresses (Care Compare)

730 Goodlette Rd
Suite 102
Naples, FL 34102-5617
Phone (239) 430-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14355TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Leg Center PA CurrentSince Sep 15, 2024 Accepting new patients
Family Foot and Leg Center PA CurrentSince Sep 15, 2024 Accepting new patients
Advanced Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

12250 Tamiami Trl E
Ste 101
Naples, FL 34113
Phone (239) 417-2256

730 Goodlette Rd
Ste 102
Naples, FL 34102
Phone (231) 343-2027

Interoperability endpoints

  • Direct secure messaging: logan.arena.1@9455.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9455/brand/1/csg/1/fhir/r4

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1104371608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1677 ATLANTA PLAZA DR",
            "city": "SANIBEL",
            "state": "FL",
            "postal_code": "339574327",
            "telephone_number": "508-868-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 S DALE MABRY HWY",
            "address_2": "SUITE 110",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111404",
            "telephone_number": "813-250-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARENA",
        "first_name": "LOGAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-25",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.