Individual provider Active NPI

Andre Nino Osie, PT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1194712679
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
35735 Issued in FL
Practice address
9685 Lake Nona Village PL Ste 205
Orlando, FL 32827-7322
Phone
(407) 972-0065
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 35735 FL Primary

Addresses

Primary practice location

9685 Lake Nona Village PL Ste 205
Orlando, FL 32827-7322

Mailing address

164 Mante Dr
Kissimmee, FL 34743-7718
Phone (917) 517-5363

Other identifiers 1

IdentifierTypeStateIssuer
35735OtherFLLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140318000782 NY Practitioner - Physical Therapist in Private Practice 4789864588 Reassigns benefits to 1 organization
I20250113000536 FL Practitioner - Physical Therapist in Private Practice 4789864588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Regeneration and Rehabilitation Center LLCGroup PAC ID 2365703816, 2 clinicians

Practice addresses (Care Compare)

9685 Lake Nona Village Place
Suite 205
Orlando, FL 32827-7320
Phone (407) 627-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026066NYMDClinical Psychologist
35735FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Regeneration and Rehabilitation Center LLC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Prokinetics Physical Therapy P.C. Physical Therapist CurrentSince Jun 15, 2023 Accepting new patients

Locations

9685 Lake Nona Village Pl
Ste 205
Orlando, FL 32827
Phone (407) 627-1148

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1194712679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 MANTE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347437718",
            "telephone_number": "917-517-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9685 LAKE NONA VILLAGE PL STE 205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277322",
            "telephone_number": "407-972-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSIE",
        "first_name": "ANDRE",
        "middle_name": "NINO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "35735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "35735",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.