Individual provider Active NPI

Krysten Saccocio, PT, DPT

  • Physical Therapist
  • Wellington, FL
National Provider Identifier
1144775073
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 31784 Issued in FL
Practice address
12797 Forest Hill Blvd
Suite B
Wellington, FL 33414-4763
Phone
(561) 296-2966
NPI assigned
Aug 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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 PT 31784 FL Primary

Addresses

Primary practice location

12797 Forest Hill Blvd
Suite B
Wellington, FL 33414-4763

Mailing address

10745 NW 11TH St
Pembroke Pines, FL 33026-5922
Phone (954) 243-3650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170123000487 FL Practitioner - Physical Therapist in Private Practice 3072895382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12797 Forest Hill Blvd
Suite B
Wellington, FL 33414-4763
Phone (561) 793-5550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 31784FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Action Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Action Physical Therapy, LLC Physical Therapist Current Accepting new patients
Action Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Physical Therapy by Design LLC Physical Therapist CurrentSince Jan 9, 2018 Accepting new patients

Locations

1905 Clint Moore Rd
Ste 305
Boca Raton, FL 33496
Phone (561) 208-5515

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

10151 Entrprs Cntr Blvd
Ste 104
Boynton Beach, FL 33437
Phone (561) 572-3220

106 Ponce de Leon St
Royal Palm Beach, FL 33411
Phone (561) 236-3741

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": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1144775073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10745 NW 11TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265922",
            "telephone_number": "954-243-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12797 FOREST HILL BLVD",
            "address_2": "SUITE B",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144763",
            "telephone_number": "561-296-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCOCIO",
        "first_name": "KRYSTEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-21",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 31784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.