Danielle Nicole Modak, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30674 Issued in FL

Practice address

113 W Chipola Ave Ste 219
Deland, FL 32720-7512

Phone

(386) 873-7590

Fax

(866) 237-9650

NPI assigned

Dec 22, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Danielle Nicole Goulet Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Therapy Partners Solutions, LLC

  • Physical Therapist
  • Deland, FL
  • NPI 1295101806
  NPD (past)

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450742400000",
    "number": "1336504190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1975",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301621975",
            "telephone_number": "386-873-7590",
            "fax_number": "866-237-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W CHIPOLA AVE STE 219",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207512",
            "telephone_number": "386-873-7590",
            "fax_number": "866-237-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODAK",
        "first_name": "DANIELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-22",
        "last_updated": "2015-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "GOULET",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrew David Mills, D.P.T
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• Angela Minett, BCABA
• Michelle Miranda
• Marjan Mirkheshti, DMD
• Mohan L Sharma MD PA
• Mohan L Sharma MD PA
• Jolie Alyssa Dickey Molina Maldonado, MS, RMHCI
• Lynn Mondelus
• Thomas Jude Montaldo, M.D.

• Physical Therapist in Deland, FL
• Providers in Deland, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2015; 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.