Individual provider Active NPI

Irina Ioana Damjanovic, DPT

  • Physical Therapist
  • Saint Augustine, FL
National Provider Identifier
1306528880
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40331 Issued in FL
Practice address
105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251
Phone
(904) 217-4259
Fax
(904) 217-4251
NPI assigned
Aug 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 PT40331 FL Primary

Addresses

Primary practice location

105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251

Mailing address

105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251
Phone (904) 217-4259

Other identifiers 1

IdentifierTypeStateIssuer
PT40331OtherFLFLORIDA DEPARTMENT OF HEALTH

Other names 1

  • Irina Ioana Iacob Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823002394 FL Practitioner - Physical Therapist in Private Practice 1355704438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

105 Mariner Health Way
Suite 213
St Augustine, FL 32086-3251
Phone (904) 217-4259

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
81.67
Improvement activities
40
Cost
71.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Rehab and Sports Medicine Physical Therapist CurrentSince Aug 2, 2023 Accepting new patients
Saint Augustine Rehabilitation Specialists LLC Physical Therapist CurrentSince May 31, 2025 Accepting new patients

Locations

360 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 446-4101

360 Palm Coast Pkwy NE
#N
Palm Coast, FL 32137
Phone (386) 446-4101

105 Mariner Health Way
Ste 213
St Augustine, FL 32086
Phone (904) 217-4259

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": "1691020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1306528880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMJANOVIC",
        "first_name": "IRINA",
        "middle_name": "IOANA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PT40331",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRINA",
            "last_name": "IACOB",
            "middle_name": "IOANA",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.