Individual provider Active NPI

Robert A Goldman, P.T.

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1144415571
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22544 Issued in FL
Practice address
12700 Creekside LN
Suite 101
Fort Myers, FL 33919-3356
Phone
(239) 432-0774
Fax
(239) 432-0229
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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 PT22544 FL Primary

Addresses

Primary practice location

12700 Creekside LN
Suite 101
Fort Myers, FL 33919-3356

Mailing address

1807 SE 41St St
#11
Cape Coral, FL 33904-6003
Phone (239) 432-0774

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
PT22544FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuroscience and Spine Associates PL Past Accepting new patients
Hazel Dell Sports Medicine & Rehab Clinic PLLC PastSince Mar 1, 2002 Accepting new patients
Cascade Park Sports Medicine & Rehab Clinic PLLC Past Accepting new patients
Concepts in Rehab Inc Past Accepting new patients
Gehm Chiropractic Services Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1144415571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SE 41ST ST",
            "address_2": "#11",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339046003",
            "telephone_number": "239-432-0774",
            "fax_number": "239-432-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 CREEKSIDE LN",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193356",
            "telephone_number": "239-432-0774",
            "fax_number": "239-432-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.