Individual provider Active NPI

Akshay Samant

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1437600509
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34416 Issued in FL
Practice address
405 N Wickham Rd Ste 103
Melbourne, FL 32935-8628
Phone
(321) 327-8509
NPI assigned
Oct 24, 2016
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011827A IN
Physical Therapist 225100000X PT34416 FL Primary

Addresses

Primary practice location

405 N Wickham Rd Ste 103
Melbourne, FL 32935-8628

Mailing address

4855 Lake Waterford Way W
Melbourne, FL 32901-8412
Phone (317) 666-1277

Other practice location 1

405 N Wickham Rd
Melbourne, FL 32935-8628
Phone (321) 327-8509

Other practice location 2

506 E. Southway Blvd
Kokomo, IN 46902-3820
Phone (765) 626-0299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191121001309 FL Practitioner - Physical Therapist in Private Practice 5890073555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Axispro Physical Therapy LLCGroup PAC ID 5395035158, 9 clinicians

Practice addresses (Care Compare)

405 N Wickham Rd
Suite 103
Melbourne, FL 32935-8628
Phone (321) 327-8509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT34416FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axispro Physical Therapy LLC CurrentSince Sep 22, 2019 Accepting new patients

Locations

405 N Wickham Rd
Ste 103
Melbourne, FL 32935
Phone (321) 327-8509

5240 Babcock St NE
Ste 102
Palm Bay, FL 32905
Phone (321) 327-8509

760 Barnes Blvd
Ste 103
Rockledge, FL 32955
Phone (321) 327-8509

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1437600509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 LAKE WATERFORD WAY W",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018412",
            "telephone_number": "317-666-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WICKHAM RD STE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358628",
            "telephone_number": "321-327-8509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 N Wickham Rd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329358628",
            "country_code": "US",
            "telephone_number": "321-327-8509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "506 E. SOUTHWAY BLVD",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023820",
            "country_code": "US",
            "telephone_number": "765-626-0299",
            "fax_number": "765-864-2070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMANT",
        "first_name": "AKSHAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-24",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011827A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.