Individual provider Active NPI

Edilberto Josef Santiago Jr., PT

  • Physical Therapist
  • Saint Petersburg, FL
National Provider Identifier
1265384408
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27106 Issued in FL
Practice address
4600 54TH Ave S
Saint Petersburg, FL 33711-4664
Phone
(727) 288-9123
NPI assigned
Feb 11, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 PT27106 FL Primary

Addresses

Primary practice location

4600 54TH Ave S
Saint Petersburg, FL 33711-4664

Mailing address

5645 16TH Ave N
Saint Petersburg, FL 33710-5720
Phone (941) 718-3476

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260303002436 FL Practitioner - Physical Therapist in Private Practice 0244712958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Philadelphia, PA 19182

PO Box
Suite 821322
Philadelphia, PA 19182-1322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT27106FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Feb 13, 2026 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Feb 13, 2026 Accepting new patients

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": "1770768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1265384408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 16TH AVE N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337105720",
            "telephone_number": "941-718-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 54TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337114664",
            "telephone_number": "727-288-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "EDILBERTO",
        "middle_name": "JOSEF",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-11",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.