Individual provider Active NPI

Edwin Enrique Tinoco, MSPT, OCS, A.T.C

  • Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1114144250
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13601 Issued in FL
Practice address
1501 Corporate Dr
Suite 110
Boynton Beach, FL 33426-6600
Phone
(561) 733-7677
Fax
(561) 733-7040
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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 PT13601 FL Primary

Addresses

Primary practice location

1501 Corporate Dr
Suite 110
Boynton Beach, FL 33426-6600

Mailing address

1501 Corporate Dr
Suite 110
Boynton Beach, FL 33426-6600
Phone (561) 733-7677

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
30347CAMDGeneral Practice Dentistry
PT13601FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Integrated Manual Physical Therapy, PA Physical Therapist PastSince Sep 1, 2011 Accepting new patients

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24436/brand/1/csg/1/fhir/r4

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1114144250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 CORPORATE DR",
            "address_2": "SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266600",
            "telephone_number": "561-733-7677",
            "fax_number": "561-733-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 CORPORATE DR",
            "address_2": "SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266600",
            "telephone_number": "561-733-7677",
            "fax_number": "561-733-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINOCO",
        "first_name": "EDWIN",
        "middle_name": "ENRIQUE",
        "credential": "MSPT, OCS, A.T.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT13601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.