Kevin Joseph Peckovitch, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT42373 Issued in FL

Practice address

4150 Wycliffe Country Club Blvd
Lake Worth, FL 33449-8149

Phone

(561) 472-6537

NPI assigned

Oct 13, 2021

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4

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.

• Orthosc, LLC

  • Orthopaedic Surgery Physician
  • Conway, SC
  • NPI 1275369787
  NPD
• Orthosc, LLC

  dba OrthoSC

  • Orthopaedic Surgery Physician
  • Murrells Inlet, SC
  • NPI 1861902728
  NPD
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD (past)
• Orthosc, LLC

  • Orthopaedic Surgery Physician
  • North Myrtle Beach, SC
  • NPI 1568100691
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1316609605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DEDRICK RD",
            "city": "CATSKILL",
            "state": "NY",
            "postal_code": "124145409",
            "telephone_number": "518-821-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 WYCLIFFE COUNTRY CLUB BLVD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334498149",
            "telephone_number": "561-472-6537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6511 Spring Brook Ave",
            "address_purpose": "LOCATION",
            "city": "Rhinebeck",
            "state": "NY",
            "postal_code": "125723709",
            "country_code": "US",
            "telephone_number": "845-876-3001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECKOVITCH",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047756",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PBND Care Inc
• PBS
• PCC Medical Holdings LLC
• PCP Specialists of the Palm Beaches, LLC
• Beatriz Pealaez
• Pirkko Pedersen, DDS
• Pediatric Medical Associates, LLC.
• Pedikidz of Florida Corp
• Pedikidz of Palm Beach
• Pedikidz of Palm Beach Therapy

• Physical Therapist in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.