Individual provider Active NPI

Madison Castelli

  • Physical Therapist
  • Temple Terrace, FL
National Provider Identifier
1245913672
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40683 Issued in FL
Practice address
10610 N 56TH St
Temple Terrace, FL 33617-3641
Phone
(813) 983-0440
NPI assigned
Aug 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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 40683 FL Primary

Addresses

Primary practice location

10610 N 56TH St
Temple Terrace, FL 33617-3641

Mailing address

211 Sun Vista CT S
Treasure Island, FL 33706-4413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123004954 FL Practitioner - Physical Therapist in Private Practice 5496107666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Performance and Physical Therapies Tyrone, LLCGroup PAC ID 6507299583, 4 clinicians

Practice addresses (Care Compare)

1700 66TH St N
Suite 102
St Petersburg, FL 33710-5510
Phone (727) 202-4627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40683FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance & Physical Therapies Tyrone, LLC Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Optimal Performance and Physical Therapies St. Petersburg, LLC Physical Therapist PastSince Jan 8, 2024 Accepting new patients

Locations

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

1700 66th St N
Ste 102
St Petersburg, FL 33710
Phone (727) 202-4627

Organizations & group practices 2

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1245913672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SUN VISTA CT S",
            "city": "TREASURE ISLAND",
            "state": "FL",
            "postal_code": "337064413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 N 56TH ST",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336173641",
            "telephone_number": "813-983-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLI",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "40683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Terrace, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.