Active NPI
Bruce Gerard Sack, PT
- Physical Therapist
- Gainesville, FL
National Provider Identifier
1396750964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 4102
- Practice address
- 7701 SW 56TH Ave
Gainesville, FL 32608-4406 - Phone
- (352) 371-4637
- NPI assigned
- Jul 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 4102 | FL | Primary |
Addresses
Primary practice location
7701 SW 56TH Ave
Gainesville, FL 32608-4406
Mailing address
7701 SW 56TH Ave
Gainesville, FL 32608-4406
Phone (352) 371-4637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5201 Nw34Th Blvd
Gainesville, FL 32605-1153
Phone (352) 240-1136
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 4102 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Day Wellness LLC | Current | Accepting new patients | |
| New Day Wellness, LLC | Physical Therapist | Past | Accepting new patients |
| New Day Wellness, LLC | Physical Therapist | Past | Accepting new patients |
Locations
5201 NW 34th Blvd
Gainesville, FL 32605
Phone (352) 240-1136
Organizations & group practices 3
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.
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- Geriatric Physical Therapist
- Chiefland, FL
- NPI 1063523496
-
- Physical Therapist
- Gainesville, FL
- NPI 1639568298
-
- Physical Therapist
- Gainesville, FL
- NPI 1982051801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396750964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7701 SW 56TH AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084406",
"telephone_number": "352-371-4637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7701 SW 56TH AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326084406",
"telephone_number": "352-371-4637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACK",
"first_name": "BRUCE",
"middle_name": "GERARD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 4102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.