NPIMap

Organization Active NPI

Optimal Performance and Physical Therapies Trinity LLC

  • Physical Therapist
  • Trinity, FL
National Provider Identifier
1144734591
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES TRINITY LLC
Practice address
11157 Trinity Blvd
Trinity, FL 34655
Phone
(813) 381-6778
NPI assigned
Nov 21, 2017
Last updated
Nov 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Authorized official

Name
Beth PattersonNPI 1215051776
Title
Chief of Compliance, Privacy and SE
Phone
(813) 690-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

11157 Trinity Blvd
Trinity, FL 34655

Mailing address

3903 Northdale Blvd Ste 111W
Tampa, FL 33624-1853
Phone (813) 381-6778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180427002359 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921362963 Receives reassigned benefits from 12 practitioners
Practice locations: Trinity, FL

National Provider Directory

National Provider Directory

Locations

11157 Trinity Blvd
Trinity, FL 34655
Phone (727) 645-4120

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1144734591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 NORTHDALE BLVD STE 111W",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336241853",
            "telephone_number": "813-381-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11157 TRINITY BLVD",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "813-381-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES TRINITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "CHIEF OF COMPLIANCE, PRIVACY AND SE",
        "authorized_official_telephone_number": "813-690-4414"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.