Individual provider Active NPI

Carmen E Osterhout, PT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1295818466
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27723 Issued in FL
Practice address
4343 Hollygate Dr
Jacksonville, FL 32258-1337
Phone
(630) 659-6783
NPI assigned
Oct 23, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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 PT27723 FL Primary

Addresses

Primary practice location

4343 Hollygate Dr
Jacksonville, FL 32258-1337

Mailing address

4343 Hollygate Dr
Jacksonville, FL 32258-1337
Phone (630) 659-6783

Other names 1

  • Carmen Moreno Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251010001781 FL Practitioner - Physical Therapist in Private Practice 8426153891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ap Therapy LLCGroup PAC ID 9032552559, 56 clinicians

Practice addresses (Care Compare)

10790 Old Saint Augustine Rd
Jacksonville, FL 32257-1078
Phone (800) 380-9153

1248 Kingsley Ave
Orange Park, FL 32073-4699
Phone (800) 380-9153

1297 US Hwy 27 N
Lake Placid, FL 33852-7907
Phone (800) 380-9153

6895 Belfort Oaks PL
Jacksonville, FL 32216-6242
Phone (800) 380-9153

9601 Southbrook Dr
Jacksonville, FL 32256-0601
Phone (800) 380-9153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Therapy LLC Physical Therapist CurrentSince Oct 1, 2025 Accepting new patients
Ap Therapy LLC Physical Therapist CurrentSince Oct 1, 2025 Accepting new patients
Wauconda Physical Therapy, Inc. Physical Therapist PastSince Sep 3, 2002 Accepting new patients

Locations

1297 US Highway 27 N
Lake Placid, FL 33852
Phone (407) 276-5023

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1295818466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 HOLLYGATE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581337",
            "telephone_number": "630-659-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 HOLLYGATE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581337",
            "telephone_number": "630-659-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERHOUT",
        "first_name": "CARMEN",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "MORENO",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.