Individual provider Active NPI

Lawrence A Bertolino, P.T.

  • Physical Therapist
  • Sarasota, FL
National Provider Identifier
1275562183
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20421 Issued in FL
Practice address
5023 Ringwood MDW
BLDG F
Sarasota, FL 34235-2035
Phone
(941) 360-9706
Fax
(941) 360-8032
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 PT20421 FL Primary

Addresses

Primary practice location

5023 Ringwood MDW
BLDG F
Sarasota, FL 34235-2035

Mailing address

8913 Bernberry Street
Sarasota, FL 34240
Phone (941) 350-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20421FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Physical Therapy, LLC Physical Therapist PastSince Mar 27, 2022 Accepting new patients

Organizations & group practices 1

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1275562183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8913 BERNBERRY STREET",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34240",
            "telephone_number": "941-350-0006",
            "fax_number": "941-379-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5023 RINGWOOD MDW",
            "address_2": "BLDG F",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342352035",
            "telephone_number": "941-360-9706",
            "fax_number": "941-360-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLINO",
        "first_name": "LAWRENCE",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20421",
            "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 Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.