Individual provider Active NPI

Jonathan Castro Tigre, DPT

  • Physical Therapist
  • Durham, NC
National Provider Identifier
1336921196
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P22713 Issued in NC
Practice address
1821 Martin Luther King Pkwy
Durham, NC 27707-6336
Phone
(919) 748-4980
Fax
(919) 816-2012
NPI assigned
Oct 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 P22713 NC Primary

Addresses

Primary practice location

1821 Martin Luther King Pkwy
Durham, NC 27707-6336

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (502) 882-9379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231206003297 NC Practitioner - Physical Therapist in Private Practice 3173972882 Reassigns benefits to 1 organization
I20260312004022 FL Practitioner - Physical Therapist in Private Practice 3173972882 Reassigns benefits to 1 organization

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
Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians
Breakthrough Physical Therapy IncGroup PAC ID 9234274754, 110 clinicians

Practice addresses (Care Compare)

3657 Cortez Rd W
Suite 110
Bradenton, FL 34210-3171
Phone (941) 739-7828

4701 Creedmoor Rd
Suite 107
Raleigh, NC 27612-4500
Phone (919) 676-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Oct 22, 2023 Accepting new patients
Fitness Quest - Venice LLC CurrentSince Mar 6, 2026 Accepting new patients
Fitness Quest - Venice LLC Physical Therapist CurrentSince Mar 6, 2026 Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist CurrentSince Oct 17, 2023 Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist PastSince Oct 17, 2023 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients

Locations

3657 Cortez Rd W
Ste 110
Bradenton, FL 34210
Phone (941) 361-9020

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

1821 Martin Luther King Pkwy
Durham, NC 27707
Phone (919) 748-4980

303 N 35th St
Morehead City, NC 28557
Phone (252) 247-2738

4701 Creedmoor Rd
Ste 107
Raleigh, NC 27612
Phone (919) 676-2001

Organizations & group practices 6

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": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1336921196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "502-882-9379",
            "fax_number": "502-587-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 MARTIN LUTHER KING PKWY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076336",
            "telephone_number": "919-748-4980",
            "fax_number": "919-816-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO TIGRE",
        "first_name": "JONATHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P22713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.