Active NPI
Mary Grace Doroteo, PT, DPT, NCS, GCS
- Physical Therapist
- Tallahassee, FL
National Provider Identifier
1376960054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT31194
- Practice address
- 2181 Orange Ave E
Tallahassee, FL 32311-6144 - Phone
- (386) 755-3016
- NPI assigned
- Mar 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 037005 | NY | |
| Physical Therapist | 225100000X | PT31194 | FL | Primary |
Addresses
Primary practice location
2181 Orange Ave E
Tallahassee, FL 32311-6144
Mailing address
2181 Orange Ave E
Tallahassee, FL 32311-6144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT31194 | FL | MD | Physical Therapist |
| 037005 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1376960054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2181 ORANGE AVE E",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323116144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2181 ORANGE AVE E",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323116144",
"telephone_number": "386-755-3016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOROTEO",
"first_name": "MARY GRACE",
"credential": "PT, DPT, NCS, GCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-19",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "037005",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT31194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.