Individual provider Active NPI

Marjorie Bergiste-Raphael

  • Physical Therapist
  • Lake Worth, FL
National Provider Identifier
1235522590
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30063 Issued in FL
Practice address
6169 S Jog Rd Ste A11
Lake Worth, FL 33467-6586
Phone
(561) 432-0111
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 30063 FL Primary

Addresses

Primary practice location

6169 S Jog Rd Ste A11
Lake Worth, FL 33467-6586

Mailing address

6114 Newport Village Way
Lake Worth, FL 33463-7330
Phone (407) 247-6114

Other names 1

  • Marjorie Bergiste Former name

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
30063FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Sobe Innovative Rehabilitation PLLC Physical Therapist CurrentSince Oct 27, 2022 Accepting new patients
Palm Beach Physical Therapy Group, LLC Physical Therapist CurrentSince Dec 13, 2021 Accepting new patients
Direct Access Counseling & Supportive Services, LLC PastSince Sep 12, 2017 Accepting new patients
Professional Therapeutic Health Care Inc Past Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

Organizations & group practices 6

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1235522590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6114 NEWPORT VILLAGE WAY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334637330",
            "telephone_number": "407-247-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 S JOG RD STE A11",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676586",
            "telephone_number": "561-432-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGISTE-RAPHAEL",
        "first_name": "MARJORIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "BERGISTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.