Individual provider Active NPI

Mary Angelie Alcala Garay Gibbs, R.P.T.

  • Physical Therapist
  • Clermont, FL
National Provider Identifier
1326086885
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5888 Issued in FL
Practice address
3721 S Highway 27
B
Clermont, FL 34711
Phone
(352) 255-6130
Fax
(407) 378-4154
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X PT5888 FL
Physical Therapist 225100000X PT5888 FL Primary

Addresses

Primary practice location

3721 S Highway 27
B
Clermont, FL 34711

Mailing address

614 E Hwy 50 # 129
Clermont, FL 34711-3164
Phone (352) 396-0952

Other practice location 1

265 W Hwy 50
Clermont, FL 34711-3027
Phone (352) 396-0952

Other practice location 2

3725 S Hwy 27
103
Clermont, FL 34711
Phone (352) 255-6130

Other identifiers 1

IdentifierTypeStateIssuer
4398900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000056 FL Practitioner - Physical Therapist in Private Practice 8426057951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
In-Home Therapy of Central Florida IncGroup PAC ID 5395875504, 2 clinicians

Practice addresses (Care Compare)

3721 S Hwy 27
Suite B
Clermont, FL 34711-7919
Phone (352) 255-6130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5888FLMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In-Home Therapy of Central Florida Inc Physical Therapist CurrentSince Oct 4, 2010 Accepting new patients
Clermont and Area Rehabilitation Solutions Inc Past Accepting new patients

Locations

3725 S Highway 27
Ste 103
Clermont, FL 34711
Phone (352) 255-6130

614 E Highway 50
Clermont, FL 34711
Phone (314) 687-5002

3721 S Highway 27
Ste B
Clermont, FL 34711
Phone (352) 255-6130

265 W State Road 50
Clermont, FL 34711
Phone (352) 255-6130

850 N Hart Blvd
Orlando, FL 32818
Phone (352) 255-6130

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1326086885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E HWY 50 # 129",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113164",
            "telephone_number": "352-396-0952",
            "fax_number": "407-378-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 S HIGHWAY 27",
            "address_2": "B",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-255-6130",
            "fax_number": "407-378-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 W Hwy 50",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347113027",
            "country_code": "US",
            "telephone_number": "352-396-0952",
            "fax_number": "407-378-4154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3725 S Hwy 27",
            "address_2": "103",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "34711",
            "country_code": "US",
            "telephone_number": "352-255-6130",
            "fax_number": "407-378-4154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARAY GIBBS",
        "first_name": "MARY ANGELIE",
        "middle_name": "ALCALA",
        "credential": "R.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT5888",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT5888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4398900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.