Individual provider Active NPI

Omar Kazzoun, DPT

  • Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1235953985
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42461 Issued in FL
Practice address
4971 Le Chalet Blvd
Suite 100
Boynton Beach, FL 33436
Phone
(561) 733-5590
NPI assigned
Nov 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 PT42461 FL Primary

Addresses

Primary practice location

4971 Le Chalet Blvd
Suite 100
Boynton Beach, FL 33436

Mailing address

4971 Le Chalet Blvd
100
Boynton Beach, FL 33436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211004501 FL Practitioner - Physical Therapist in Private Practice 0840726964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Florida International Univ, College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Royal Palm Beach Rehab, CorpGroup PAC ID 3476683335, 62 clinicians

Practice addresses (Care Compare)

4971 Le Chalet Blvd
Suite 100
Boynton Beach, FL 33436-1418
Phone (561) 733-5590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42461FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Beach Rehab, Corp Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Royal Palm Beach Rehab, Corp Physical Therapist Current Accepting new patients
Fusion Physical Therapy and Sports Wellness P.C. Physical Therapist Current Accepting new patients
Royal Palm Beach Rehab, Corp Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients

Locations

9325 Glades Rd
Ste 104
Boca Raton, FL 33434
Phone (561) 513-8380

4971 Le Chalet Blvd
Ste 100
Boynton Beach, FL 33436
Phone (561) 733-5590

Organizations & group practices 4

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": "1731283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1235953985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 LE CHALET BLVD",
            "address_2": "100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4971 LE CHALET BLVD",
            "address_2": "SUITE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33436",
            "telephone_number": "561-733-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZZOUN",
        "first_name": "OMAR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42461",
            "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 Nov 11, 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.