Organization Active NPI

All Coast Therapy Services Outpatient Inc

  • Physical Medicine & Rehabilitation Physician
  • Lady Lake, FL
National Provider Identifier
1104889260
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ALL COAST THERAPY SERVICES OUTPATIENT INC
Practice address
13940 N US Highway 441
Building 700, Suite 702
Lady Lake, FL 32159-8953
Phone
(352) 751-6005
Fax
(352) 751-5168
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Mr. Michael G Horsley, PTNPI 1629031695
Title
Owner
Phone
(352) 751-6005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

13940 N US Highway 441
Building 700, Suite 702
Lady Lake, FL 32159-8953

Mailing address

13940 North US Hwy 441
Building 700, Suite 702
Lady Lake, FL 32159-8953
Phone (352) 751-6005

Other identifiers 1

IdentifierTypeStateIssuer
RS4OtherFLBLUE SHIELD FACILITY PROV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231120003215 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6800705062 Receives reassigned benefits from 2 practitioners
Practice locations: Lady Lake, FL

National Provider Directory

National Provider Directory

Locations

13940 N US Highway 441
Ste 603
Lady Lake, FL 32159
Phone (352) 751-1095

13940 N US Highway 441
Ste 702
Lady Lake, FL 32159
Phone (352) 751-1095

740 W Burleigh Blvd
Tavares, FL 32778
Phone (352) 742-1016

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1104889260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13940 NORTH US HWY 441",
            "address_2": "BUILDING 700, SUITE 702",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598953",
            "telephone_number": "352-751-6005",
            "fax_number": "352-751-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13940 N US HIGHWAY 441",
            "address_2": "BUILDING 700, SUITE 702",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598953",
            "telephone_number": "352-751-6005",
            "fax_number": "352-751-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL COAST THERAPY SERVICES OUTPATIENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "HORSLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-751-6005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD FACILITY PROV",
            "identifier": "RS4",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.