Individual provider Active NPI

Mark Robert Iannotti

  • Orthopedic Physical Therapist
  • Venice, FL
National Provider Identifier
1386697852
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 21769 Issued in FL
Practice address
930 Tamiami TRL S
Venice, FL 34285-3653
Phone
(941) 486-5444
Fax
(941) 486-5489
NPI assigned
May 18, 2006
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 21769 FL Primary

Addresses

Primary practice location

930 Tamiami TRL S
Venice, FL 34285-3653

Mailing address

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222-5158
Phone (941) 486-5444

Other identifiers 1

IdentifierTypeStateIssuer
Y911KOtherFLBC/BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000452 FL Practitioner - Physical Therapist in Private Practice 1254368905 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loveland Center IncGroup PAC ID 2163813460, 5 clinicians
Maxider CorporationGroup PAC ID 4385619154, 12 clinicians

Practice addresses (Care Compare)

157 S Havana Rd
Venice, FL 34292-3104
Phone 9414930016320

2970 University Pkwy
Suite 105
Sarasota, FL 34243-2401
Phone 9413601988107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 21769FLMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Loveland Center, Inc. CurrentSince Sep 2, 2022 Accepting new patients
Loveland Center, Inc. CurrentSince Feb 23, 2025 Accepting new patients
West Coast Therapy Solutions LLC Orthopedic CurrentSince Feb 1, 2026 Accepting new patients
Maxider Corporation Orthopedic CurrentSince Mar 2, 2026 Accepting new patients
Progressive Physical Therapy Service Inc. Orthopedic PastSince Dec 28, 2016 Accepting new patients
U.S. Healthworks Medical Group of Florida, Inc. Past Accepting new patients
Fyzbiz, LLC Past Accepting new patients
Sunshine Rheumatology and Arthritis Center LLC Past Accepting new patients

Locations

4707 140th Ave N
Ste 302
Clearwater, FL 33762
Phone (727) 223-8978

2970 University Pkwy
Ste 105
Sarasota, FL 34243
Phone (800) 605-3182

157 S Havana Rd
Venice, FL 34292
Phone (941) 493-0016

Organizations & group practices 8

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1386697852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N HURSTBOURNE PKWY",
            "address_2": "STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225158",
            "telephone_number": "941-486-5444",
            "fax_number": "941-486-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853653",
            "telephone_number": "941-486-5444",
            "fax_number": "941-486-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNOTTI",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT 21769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y911K",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.