Organization Active NPI

Activa, LC

  • Physical Therapist
  • Cooper City, FL
National Provider Identifier
1245234848
Registry record updated Apr 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVA, LC
Practice address
9720 Stirling Rd
Suite 104
Cooper City, FL 33024-8014
Phone
(954) 374-0160
Fax
(954) 374-0163
NPI assigned
Jun 10, 2005
Last updated
Apr 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Oscar G. Ferreira
Title
Administrative Manager
Phone
(954) 374-0160

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Geriatric Physical Therapist 2251G0304X
Orthopedic Physical Therapist 2251X0800X
Physical Therapy Assistant 225200000X
Occupational Therapist 225X00000X
Pediatric Occupational Therapist 225XP0200X
Gerontology Occupational Therapist 225XG0600X
Physical Rehabilitation Occupational Therapist 225XP0019X
Low Vision Occupational Therapist 225XL0004X

Addresses

Primary practice location

9720 Stirling Rd
Suite 104
Cooper City, FL 33024-8014

Mailing address

9720 Stirling Rd
Suite 104
Cooper City, FL 33024-8014
Phone (954) 374-0160

Other identifiers 2

IdentifierTypeStateIssuer
889541400MedicaidFL
686623996MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715000521 FL Part B Supplier - Clinic/Group Practice 2668452020 Receives reassigned benefits from 7 practitioners
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Locations

9720 Stirling Rd
Ste 104
Hollywood, FL 33024
Phone (954) 374-0160

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270166400000",
    "number": "1245234848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9720 STIRLING RD",
            "address_2": "SUITE 104",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "330248014",
            "telephone_number": "954-374-0160",
            "fax_number": "954-374-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 STIRLING RD",
            "address_2": "SUITE 104",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "330248014",
            "telephone_number": "954-374-0160",
            "fax_number": "954-374-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVA, LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-04-02",
        "status": "A",
        "authorized_official_last_name": "FERREIRA",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAGER",
        "authorized_official_telephone_number": "954-374-0160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889541400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686623996",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.