Individual provider Active NPI

Martha Lynn Gonzalez, P.T.

  • Physical Therapist
  • Sarasota, FL
National Provider Identifier
1265637615
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22616 Issued in FL
Practice address
3251 Proctor Rd
Sarasota, FL 34231-8538
Phone
(941) 256-3259
NPI assigned
Jun 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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 PT22616 FL Primary

Addresses

Primary practice location

3251 Proctor Rd
Sarasota, FL 34231-8538

Mailing address

4418 Meadow Creek Cir
Sarasota, FL 34233-1805
Phone (941) 870-3848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131030001121 FL Practitioner - Physical Therapist in Private Practice 4183859044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22616FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Physical Therapy Services of Sarasota LLC Physical Therapist CurrentSince May 4, 2021 Accepting new patients
Caresouth HHA Holdings of the Bay Area, LLC Past Accepting new patients

Locations

3251 Proctor Rd
Sarasota, FL 34231
Phone (941) 256-3259

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": "1182038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1265637615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 MEADOW CREEK CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331805",
            "telephone_number": "941-870-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 PROCTOR RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342318538",
            "telephone_number": "941-256-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARTHA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-17",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.