Individual provider Active NPI

Kevin Deglado Velasco, PT

  • Physical Therapist
  • University Park, FL
National Provider Identifier
1356895544
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37543 Issued in FL
Practice address
8039 Cooper Creek Blvd Ste 102
University Park, FL 34201-3007
Phone
(941) 405-3557
Fax
(941) 248-0228
NPI assigned
Aug 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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 PT37543 FL Primary

Addresses

Primary practice location

8039 Cooper Creek Blvd Ste 102
University Park, FL 34201-3007

Mailing address

8039 Cooper Creek Blvd Ste 102
University Park, FL 34201-3007
Phone (941) 405-3557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011001075 FL Practitioner - Physical Therapist in Private Practice 2163719253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Place Rehab, LLCGroup PAC ID 6204312176, 4 clinicians
One Place Performance and Osteopractic Physical TherapyGroup PAC ID 1658803796, 4 clinicians

Practice addresses (Care Compare)

5214
Suite 64
Bradenton, FL 34208
Phone (941) 541-4571

8039 Cooper Creek Blvd
Suite 102
University Park, FL 34201-3007
Phone (941) 405-3557

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT37543FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Place Rehab, LLC Physical Therapist CurrentSince Nov 3, 2025 Accepting new patients
One Place Performance and Osteopractic Physical Therapy Physical Therapist CurrentSince Sep 16, 2024 Accepting new patients
Coastal Orthopedics & Sports Medicine of Southwest FL, PA PastSince Nov 1, 2021 Accepting new patients

Locations

5214 E State Road 64
Bradenton, FL 34208
Phone (727) 773-6609

8039 Cooper Creek Blvd
Ste 102
University Park, FL 34201
Phone (941) 405-3557

Organizations & group practices 3

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": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1356895544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8039 COOPER CREEK BLVD STE 102",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342013007",
            "telephone_number": "941-405-3557",
            "fax_number": "941-248-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8039 COOPER CREEK BLVD STE 102",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "342013007",
            "telephone_number": "941-405-3557",
            "fax_number": "941-248-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "KEVIN",
        "middle_name": "DEGLADO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-05",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.