Individual provider Active NPI

Alyssa Lauren Harris, PT, DPT

  • Physical Therapist
  • Estero, FL
National Provider Identifier
1104699057
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40819 Issued in FL
Practice address
9250 Corkscrew Rd Ste 10
Estero, FL 33928-3216
Phone
(239) 390-1656
NPI assigned
Nov 2, 2023
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 PT40819 FL Primary

Addresses

Primary practice location

9250 Corkscrew Rd Ste 10
Estero, FL 33928-3216

Mailing address

9070 W Cheyenne Ave Ste 100
Las Vegas, NV 89129-8935
Phone (702) 818-5000

Other practice location 1

25241 Elementary Way Ste 200
Bonita Springs, FL 34135-7883
Phone (239) 947-4184

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240102001119 FL Practitioner - Physical Therapist in Private Practice 1355791484 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sobe Innovative Rehabilitation PLLCGroup PAC ID 4789994336, 178 clinicians
On Site Physical Therapy LLCGroup PAC ID 7810916897, 21 clinicians

Practice addresses (Care Compare)

279 NW California Blvd
Port Saint Lucie, FL 34986-2507
Phone (786) 770-9480

8100 Ibis Blvd
West Palm Beach, FL 33412-1573
Phone (561) 632-2160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40819FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
On Site Physical Therapy LLC Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Sobe Innovative Rehabilitation PLLC Physical Therapist CurrentSince Jul 16, 2024 Accepting new patients
Dynamic Mobile Rehab LLC Physical Therapist CurrentSince Dec 1, 2023 Accepting new patients
Fyzbiz, LLC Physical Therapist PastSince Aug 1, 2022 Accepting new patients
Physiotherapy Associates Inc PastSince Nov 5, 2023 Accepting new patients
Sports and Orthopedic Rehabilitation Services, Inc. PastSince Nov 5, 2023 Accepting new patients
Douglass Orthopedic & Spine Rehabilitation, Inc. Physical Therapist PastSince Jul 1, 2001 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

200 Admirals Cove Blvd
Jupiter, FL 33477
Phone (561) 745-5920

521 Lake Ave
Ste 8
Lake Worth, FL 33460
Phone (305) 484-0832

8100 Ibis Blvd
West Palm Beach, FL 33412
Phone (561) 625-8500

Networks

  • Freedom Health HMO Network

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1104699057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298935",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 CORKSCREW RD STE 10",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283216",
            "telephone_number": "239-390-1656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25241 Elementary Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bonita Springs",
            "state": "FL",
            "postal_code": "341357883",
            "country_code": "US",
            "telephone_number": "239-947-4184",
            "fax_number": "239-947-4171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ALYSSA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.