Individual provider Active NPI

Hesham M Ismail, PT, DPT, CSCS

  • Physical Therapist
  • Lake Alfred, FL
National Provider Identifier
1194962050
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24475 Issued in FL
Practice address
290 S Carolina Ave
Lake Alfred, FL 33850-2929
Phone
(863) 521-6560
NPI assigned
Jan 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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 24475 FL Primary

Addresses

Primary practice location

290 S Carolina Ave
Lake Alfred, FL 33850-2929

Mailing address

290 S Carolina Ave
Lake Alfred, FL 33850-2929
Phone (863) 521-6560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24475FLMDPhysical Therapist

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1194962050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 S CAROLINA AVE",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502929",
            "telephone_number": "863-521-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S CAROLINA AVE",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502929",
            "telephone_number": "863-521-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "HESHAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "24475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Alfred, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.