Peter Dominianni, M.S., P.T.

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

PT24515 Issued in FL

Practice address

11223 Edgewater Cir
Wellington, FL 33414-8831

Phone

(561) 531-9333

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Kevin Pallone MPT PA

  • Physical Therapist
  • Boynton Beach, FL
  • NPI 1417136417

  Geriatrics

  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1336280882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4249 BLUFF HARBOR WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498322",
            "telephone_number": "561-531-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11223 EDGEWATER CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148831",
            "telephone_number": "561-531-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINIANNI",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "M.S., P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "022369",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT24515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Wellington, FL
• Providers in Wellington, FL by specialty
• Geriatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.