Individual provider Active NPI

Geraldine Grace Cendana-Malvas, RPT

  • Physical Therapist
  • North Port, FL
National Provider Identifier
1144409855
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10461 Issued in FL
Practice address
14866 Tamiami TRL
Suite 204
North Port, FL 34287-2701
Phone
(941) 423-7705
Fax
(941) 423-7712
NPI assigned
Oct 30, 2007
Last updated
Nov 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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 PT10461 FL Primary

Addresses

Primary practice location

14866 Tamiami TRL
Suite 204
North Port, FL 34287-2701

Mailing address

14866 Tamiami TRL
Suite 204
North Port, FL 34287-2701
Phone (941) 423-7705

Other identifiers 1

IdentifierTypeStateIssuer
YO52QOtherFLBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000262 FL Practitioner - Physical Therapist in Private Practice 8224009972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14866 Tamiami TRL
North Port, FL 34287-2701
Phone (941) 423-7705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT10461FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Step Up Physical Therapy & Rehabilitation, Inc Physical Therapist CurrentSince Apr 19, 2004 Accepting new patients

Locations

14866 Tamiami Trl
North Port, FL 34287
Phone (941) 423-7705

14866 Tamiami Trl
Ste 204
North Port, FL 34287
Phone (941) 423-7705

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, 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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1144409855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14866 TAMIAMI TRL",
            "address_2": "SUITE 204",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872701",
            "telephone_number": "941-423-7705",
            "fax_number": "941-423-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14866 TAMIAMI TRL",
            "address_2": "SUITE 204",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872701",
            "telephone_number": "941-423-7705",
            "fax_number": "941-423-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENDANA-MALVAS",
        "first_name": "GERALDINE",
        "middle_name": "GRACE",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "YO52Q",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.