Individual provider Active NPI

James Raytsin

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1366922254
Registry record updated Aug 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT35846 Issued in FL
Practice address
10560 SW Stephanie Way Apt 202
Port St Lucie, FL 34987-2328
Phone
(772) 238-0702
NPI assigned
Aug 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 PT35846 FL Primary

Addresses

Primary practice location

10560 SW Stephanie Way Apt 202
Port St Lucie, FL 34987-2328

Mailing address

10560 SW Stephanie Way Apt 202
Port St Lucie, FL 34987-2328
Phone (772) 238-0702

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200325001808 NJ Practitioner - Physical Therapist in Private Practice 4880022839 Reassigns benefits to 1 organization
I20201116000331 FL Practitioner - Physical Therapist in Private Practice 4880022839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Care Physical Therapy Physical Therapist CurrentSince Feb 16, 2021 Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Feb 22, 2020 Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

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": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693094400000",
    "number": "1366922254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10560 SW STEPHANIE WAY APT 202",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872328",
            "telephone_number": "772-238-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 SW STEPHANIE WAY APT 202",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872328",
            "telephone_number": "772-238-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYTSIN",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2023-08-27",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT35846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.