Individual provider Active NPI

Samantha Gusman, PT DPT

  • Physical Therapist
  • Delray Beach, FL
National Provider Identifier
1366936338
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT33620 Issued in FL
Practice address
4800 Linton Blvd Ste F116
Delray Beach, FL 33445-6583
Phone
(561) 498-1423
Fax
(561) 883-6161
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 PT33620 FL Primary

Addresses

Primary practice location

4800 Linton Blvd Ste F116
Delray Beach, FL 33445-6583

Mailing address

12585 SW 69TH Ave
Pinecrest, FL 33156-6216
Phone (786) 290-2041

Other identifiers 1

IdentifierTypeStateIssuer
PT33620OtherFLPHYSICAL THERAPIST LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240530001138 FL Practitioner - Physical Therapist in Private Practice 3375985708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT33620FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince May 7, 2024 Accepting new patients
Physical Therapy Institute Inc Physical Therapist PastSince Aug 16, 2001 Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1366936338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12585 SW 69TH AVE",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331566216",
            "telephone_number": "786-290-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LINTON BLVD STE F116",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456583",
            "telephone_number": "561-498-1423",
            "fax_number": "561-883-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSMAN",
        "first_name": "SAMANTHA",
        "credential": "PT DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT33620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE",
            "identifier": "PT33620",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.