Individual provider Active NPI

Abigail Ann Bair

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1235849746
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39671 Issued in FL
Practice address
2080 W Eau Gallie Blvd
Melbourne, FL 32935-3152
Phone
(407) 694-3603
NPI assigned
Nov 25, 2022
Last updated
Dec 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2022

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 39671 FL Primary

Addresses

Primary practice location

2080 W Eau Gallie Blvd
Melbourne, FL 32935-3152

Mailing address

2080 W Eau Gallie Blvd
Melbourne, FL 32935-3152
Phone (407) 694-3603

Other practice location 1

405 N Wickham Rd Ste 103
Melbourne, FL 32935-8628
Phone (321) 327-8507

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216001690 FL Practitioner - Physical Therapist in Private Practice 7214371319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Professionals LLCGroup PAC ID 2567461825, 14 clinicians

Practice addresses (Care Compare)

8045 Spyglass Hill Rd
Suite 103
Melbourne, FL 32940-8567
Phone (321) 757-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39671FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Professionals, LLC Physical Therapist CurrentSince Feb 7, 2024 Accepting new patients

Locations

8045 Spyglass Hill Rd
Ste 103
Melbourne, FL 32940
Phone (321) 757-5515

470 Malabar Rd SE
Unit 102
Palm Bay, FL 32907
Phone (321) 591-4369

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670112000000",
    "number": "1235849746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353152",
            "telephone_number": "407-694-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353152",
            "telephone_number": "407-694-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 N Wickham Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329358628",
            "country_code": "US",
            "telephone_number": "321-327-8507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIR",
        "first_name": "ABIGAIL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "39671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2022; 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.