Individual provider Active NPI

Javier Busutil, DPT

  • Physical Therapist
  • Doral, FL
National Provider Identifier
1386017580
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 30957 Issued in FL
Practice address
2786 NW 79TH Ave
Doral, FL 33122-1067
Phone
(305) 281-5124
Fax
(305) 960-7629
NPI assigned
Nov 10, 2015
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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 PT 30957 FL Primary

Addresses

Primary practice location

2786 NW 79TH Ave
Doral, FL 33122-1067

Mailing address

200 NW 136TH Ave
Miami, FL 33182-1955
Phone (305) 281-5124

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200729001548 FL Practitioner - Physical Therapist in Private Practice 5496170151 Reassigns benefits to 3 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
Nandy Community Wellness Center CorpGroup PAC ID 8123354016, 3 clinicians

Practice addresses (Care Compare)

11009 SW 186TH St
Cutler Bay, FL 33157-6810
Phone (786) 732-7979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 30957FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jun 28, 2022 Accepting new patients
N&Y Community Wellness Center Corp Physical Therapist CurrentSince Mar 25, 2025 Accepting new patients
Proactive Health Corp Physical Therapist Past Accepting new patients

Locations

10973 SW 186th St
Cutler Bay, FL 33157
Phone (786) 732-7979

11009 SW 186th St
Cutler Bay, FL 33157
Phone (786) 608-0710

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Complete Health Network, Inc.Miami, FL, CCN 108074 Home health agency Corporate Officer
Corporate Director
W-2 Managing Employee
Operational/Managerial Control
Aug 5, 2022
Aug 5, 2022
Aug 5, 2022
Aug 5, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1386017580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NW 136TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331821955",
            "telephone_number": "305-281-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2786 NW 79TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221067",
            "telephone_number": "305-281-5124",
            "fax_number": "305-960-7629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSUTIL",
        "first_name": "JAVIER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 30957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.