Beachside Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BEACHSIDE PHYSICAL THERAPY INC

Practice address

4270 Minton Rd
Ste 120
West Melbourne, FL 32904-9578

Phone

(321) 984-2933

Fax

(321) 953-5379

NPI assigned

May 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gabriela Litt

Title

Credentialing Coordinator

Phone

(951) 696-9353

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Beachside Physical Therapy

  • Physical Therapist
  • Viera, FL
  • NPI 1952415622

  O20070605000506

  Same enrollment
• Beachside Physical Therapy Inc

  • Physical Therapist
  • Melbourne, FL
  • NPI 1346288974

  O20070605000506

  Same enrollment
• Beachside Physical Therapy, Inc

  • Physical Therapist
  • Melbourne, FL
  • NPI 1699713222

  O20070605000506

  Same enrollment
• Beachside Physical Therapy, Inc.

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1457390874

  O20070605000506

  Same enrollment

Tax ID family

Beachside Physical Therapy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Beachside Physical Therapy Inc

  • Physical Therapist
  • Melbourne, FL
  • NPI 1346288974
  NPD tax ID
• Beachside Physical Therapy, Inc

  • Physical Therapist
  • Melbourne, FL
  • NPI 1699713222
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lenora Corbett, PT

  • Physical Therapist
  • Melbourne, FL
  • NPI 1760442479
  NPD
• Jennifer A Fairbank, PT

  • Physical Therapist
  • West Melbourne, FL
  • NPI 1659489391
  NPD
• Peyton Lynn Richardson, PT, DPT

  • Physical Therapist
  • Melbourne, FL
  • NPI 1659083459
  NPD

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1295902450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 E EAU GALLIE BLVD SUITE 106",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374400",
            "telephone_number": "321-773-5290",
            "fax_number": "321-773-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4270 MINTON RD",
            "address_2": "STE 120",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329049578",
            "telephone_number": "321-984-2933",
            "fax_number": "321-953-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "LITT",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "951-696-9353"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK5288",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP NUMBER",
            "identifier": "Y931E",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cresselle Baptiste
• Natalie Cordeiro Barbosa, RD, LDN
• Alexandra May Barter, MS
• Jayme Leigh Bartz, PT, DPT
• Tammy Jean Bassile, RN, MA
• Chris Anne Behringer
• Vicki Ann Bell, PTA
• Beth Anne Berinato
• Lacey M Blecha, BCBA
• Blue Sky Discount Pharmacy LLC

• Physical Therapist in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.