Individual provider Active NPI

David G Ledis, MPT

  • Physical Therapist
  • West Palm Beach, FL
National Provider Identifier
1174645121
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 22675 Issued in FL
Practice address
8614 Green Cay
West Palm Beach, FL 33411-5543
Phone
(561) 676-0095
Fax
(561) 795-9426
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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 22675 FL Primary

Addresses

Primary practice location

8614 Green Cay
West Palm Beach, FL 33411-5543

Mailing address

8614 Green Cay
West Palm Beach, FL 33411-5543
Phone (561) 676-0095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229001101 FL Practitioner - Physical Therapist in Private Practice 1951451319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Beach Therapy and Fitness Providers, Inc.Group PAC ID 3274800123, 2 clinicians

Practice addresses (Care Compare)

6525 Bellaggio Lakes Blvd
Lake Worth, FL 33467-6165
Phone (561) 676-1041

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 22675FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Therapy & Fitness Providers, Inc. Physical Therapist CurrentSince Jan 1, 2018 Accepting new patients
Vital Medical Supplies Inc. PastSince Oct 17, 2012 Accepting new patients
Palm Beach Therapy & Fitness Providers, Inc. Past Accepting new patients

Locations

6525 Bellaggio Lakes Blvd
Lake Worth, FL 33467
Phone (561) 265-0410

Organizations & group practices 3

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1174645121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 GREEN CAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334115543",
            "telephone_number": "561-676-0095",
            "fax_number": "561-795-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8614 GREEN CAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334115543",
            "telephone_number": "561-676-0095",
            "fax_number": "561-795-9426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDIS",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 22675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.