Deryl Pace, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT02871 Issued in RI

Practice address

285 Governor St
Providence, RI 02906-3237

Phone

(401) 276-0800

Fax

(401) 276-0808

NPI assigned

Nov 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Elite Physical Therapy, LLC

  • Physical Therapist
  • Warwick, RI
  • NPI 1225123565

  MA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1124492822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 WINTHROP ST",
            "city": "REHOBOTH",
            "state": "MA",
            "postal_code": "027692601",
            "telephone_number": "774-565-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 GOVERNOR ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063237",
            "telephone_number": "401-276-0800",
            "fax_number": "401-276-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "DERYL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adetokunbo Adegboyega Oyelese, MD, PHD
• Nathaniel Lee Oz, MD
• Bugra Ozer, PHARMD
• Jordan Faith Ozolin, MD
• Cecilia Eliane Rosa Paasche, MD
• Paolo Giovanni Pace, M.D.
• Mayelin Pacheco Nunez, NP
• Adrian Pacheco
• Melissa Jean Pacheco, PT, DPT
• Mercedes Pacheco, MD

• Physical Therapist in Providence, RI
• Providers in Providence, RI by specialty
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.