Individual provider Active NPI

Guadalyn Luz Navarra

  • Physical Therapist
  • Newton, MA
National Provider Identifier
1114476561
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62040874 Issued in NY
Practice address
100 Needham St FL 2
Newton, MA 02464-1500
Phone
(781) 444-5141
NPI assigned
Sep 27, 2016
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 62040874 NY Primary

Addresses

Primary practice location

100 Needham St FL 2
Newton, MA 02464-1500

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

12218 W Sample Rd
Coral Springs, FL 33065-4223
Phone (732) 575-6364

Other names 1

  • Guadalyn Luz Navarra Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111001339 MA Practitioner - Physical Therapist in Private Practice 6800320078 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62040874NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist Current Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Carl Gustafson LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

100 Needham St
#2
Newton, MA 02464
Phone (781) 444-5141

Organizations & group practices 4

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1114476561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NEEDHAM ST FL 2",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641500",
            "telephone_number": "781-444-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12218 W Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330654223",
            "country_code": "US",
            "telephone_number": "732-575-6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAVARRA",
        "first_name": "GUADALYN",
        "middle_name": "LUZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62040874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUADALYN",
            "last_name": "NAVARRA",
            "middle_name": "LUZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.