Individual provider Active NPI

Brian Paul Pescatore, PT

  • Physical Therapist
  • Pembroke Pines, FL
National Provider Identifier
1255178794
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32498 Issued in FL
Practice address
17079 NW 22ND St
Pembroke Pines, FL 33028-2002
Phone
(310) 428-6021
NPI assigned
Jul 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 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 PT32498 FL Primary

Addresses

Primary practice location

17079 NW 22ND St
Pembroke Pines, FL 33028-2002

Mailing address

17079 NW 22ND St
Pembroke Pines, FL 33028-2002
Phone (310) 428-6021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819004288 FL Practitioner - Physical Therapist in Private Practice 6204837479 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jun 15, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jun 15, 2024 Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

Organizations & group practices 3

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": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1255178794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17079 NW 22ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282002",
            "telephone_number": "310-428-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17079 NW 22ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282002",
            "telephone_number": "310-428-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESCATORE",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.