Individual provider Active NPI

Cameron Lamar Rolle

  • Occupational Therapist
  • Stuart, FL
National Provider Identifier
1457904617
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT18160 Issued in FL
Practice address
2110 SE Madison St
Stuart, FL 34997-5641
Phone
(561) 236-6269
NPI assigned
Jul 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT18160 FL Primary

Addresses

Primary practice location

2110 SE Madison St
Stuart, FL 34997-5641

Mailing address

2110 SE Madison St
Stuart, FL 34997-5641
Phone (561) 236-6269

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231216000413 FL Practitioner - Occupational Therapist in Private Practice 4688023583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sobe Innovative Rehabilitation PLLCGroup PAC ID 4789994336, 178 clinicians

Practice addresses (Care Compare)

279 NW California Blvd
Port Saint Lucie, FL 34986-2507
Phone (786) 770-9480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT18160FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Strength and Balance Institute Occupational Therapist CurrentSince Nov 14, 2023 Accepting new patients
Sobe Innovative Rehabilitation PLLC Occupational Therapist CurrentSince Nov 14, 2023 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

Organizations & group practices 2

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1457904617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SE MADISON ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349975641",
            "telephone_number": "561-236-6269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 SE MADISON ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349975641",
            "telephone_number": "561-236-6269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLE",
        "first_name": "CAMERON",
        "middle_name": "LAMAR",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.