NPIMap

Organization Active NPI

Bolduc Physical Therapy Inc

  • Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1184703340
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9635 Issued in FL
Legal business name
BOLDUC PHYSICAL THERAPY INC
Practice address
11135 S Jog Road
Suite 1
Boynton Beach, FL 33437-1817
Phone
(561) 752-3820
Fax
(561) 752-5788
NPI assigned
Nov 6, 2006
Last updated
Sep 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Authorized official

Name
Mrs. Victoria Bolduc, PTNPI 1023123486
Title
President
Phone
(561) 752-3820

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 Therapist 225100000X PT9635 FL Primary

Addresses

Primary practice location

11135 S Jog Road
Suite 1
Boynton Beach, FL 33437-1817

Mailing address

11135 S Jog Road
Suite 1
Boynton Beach, FL 33437-1817
Phone (561) 752-3820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000491 FL Part B Supplier - Clinic/Group Practice 2163329343 Receives reassigned benefits from 5 practitioners
Practice locations: Coconut Creek, FL; Boynton Beach, FL

National Provider Directory

National Provider Directory

Locations

11135 S Jog Rd
Ste 1
Boynton Beach, FL 33437
Phone (561) 752-3820

3301 W Boynton Beach Blvd
Ste 2
Boynton Beach, FL 33436
Phone (561) 736-8380

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1184703340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11135 S JOG ROAD",
            "address_2": "SUITE 1",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371817",
            "telephone_number": "561-752-3820",
            "fax_number": "561-752-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11135 S JOG ROAD",
            "address_2": "SUITE 1",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371817",
            "telephone_number": "561-752-3820",
            "fax_number": "561-752-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLDUC PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "BOLDUC",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-752-3820",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT9635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.