Individual provider Active NPI

Melissa Roque, DPT

  • Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1376974766
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT88830 Issued in FL
Practice address
1903 S Congress Ave Ste 100
Boynton Beach, FL 33426-6553
Phone
(561) 432-0111
Fax
(561) 432-1075
NPI assigned
Dec 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 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 PT88830 FL Primary

Addresses

Primary practice location

1903 S Congress Ave Ste 100
Boynton Beach, FL 33426-6553

Mailing address

5840 Corporate Way Ste 101
West Palm Beach, FL 33407-2040
Phone (561) 432-0111

Other practice location 1

22 SW 4th Ave
apt c
Delray Beach, FL 33444-2506
Phone (561) 573-4293

Other identifiers 1

IdentifierTypeStateIssuer
PT28830OtherFLPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140129000202 FL Practitioner - Physical Therapist in Private Practice 1254560956 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gold Coast Physical Therapy Associates LLCGroup PAC ID 1052306271, 26 clinicians

Practice addresses (Care Compare)

1903 S Congress Ave
Suite 100
Boynton Beach, FL 33426-6553
Phone (561) 432-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT88830FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jan 24, 2023 Accepting new patients
Gold Coast Physical Therapy Associates LLC CurrentSince Mar 29, 2019 Accepting new patients
Orthopedic Center of Palm Beach County, LLC CurrentSince Jul 20, 2015 Accepting new patients
Palm Beach Aquatics & Physical Therapy Inc Physical Therapist CurrentSince Jun 1, 2016 Accepting new patients
Gold Coast Physical Therapy Associates LLC Physical Therapist Current Accepting new patients
Gold Coast Physical Therapy Associates LLC CurrentSince Mar 29, 2019 Accepting new patients
Orthopedic Center of Palm Beach County CurrentSince Jul 20, 2015 Accepting new patients
Orthopedic Center of Palm Beach County, LLC Past Accepting new patients
Mote Wellness & Rehab Inc PastSince Jun 1, 2009 Accepting new patients

Locations

3111 W Boynton Beach Blvd
Ste 200
Boynton Beach, FL 33436
Phone (561) 742-3283

3111 W Boynton Beach Blvd
Ste 20000
Boynton Beach, FL 33436
Phone (561) 865-2800

1903 S Congress Ave
Ste 100
Boynton Beach, FL 33426

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

6169 S Jog Rd
Ste A11
Lake Worth, FL 33467
Phone 5614320111 ext. 1004

4801 S Congress Ave
Palm Springs, FL 33461
Phone (407) 967-6500

5840 Corporate Way
Ste 101
West Palm Beach, FL 33407
Phone (561) 852-7352

Networks

  • Freedom Health HMO Network

Organizations & group practices 9

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": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1376974766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 CORPORATE WAY STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072040",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S CONGRESS AVE STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266553",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 SW 4th Ave",
            "address_2": "apt c",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334442506",
            "country_code": "US",
            "telephone_number": "561-573-4293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT88830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT28830",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.