NPIMap

Organization Active NPI

Fq0014

Doing business as Fitness Quest Gateway

  • Physical Therapy Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1467079368
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FQ0014
Doing business as
Fitness Quest Gateway
Practice address
11930 Fairway Lakes Dr
Ste 103
Fort Myers, FL 33913
Phone
(239) 687-3224
Fax
(239) 687-3275
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Mackenzie Bartruff
Title
Owner
Phone
(239) 687-3275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

11930 Fairway Lakes Dr
Ste 103
Fort Myers, FL 33913

Mailing address

3657 Cortez Rd W Ste 110
Bradenton, FL 34210-3171
Phone (239) 687-3275

Other names 1

  • Fitness Quest Gateway Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201007002381 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931528189 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

11930 Fairway Lakes Dr
Fort Myers, FL 33913
Phone (239) 687-3224

11930 Fairway Lakes Dr
Ste 103
Fort Myers, FL 33913
Phone (239) 687-3224

11045 Tamiami Trl S
North Port, FL 34287
Phone (877) 469-3778

Networks

  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)
  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1467079368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3657 CORTEZ RD W STE 110",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103171",
            "telephone_number": "239-687-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 FAIRWAY LAKES DR",
            "address_2": "STE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33913",
            "telephone_number": "239-687-3224",
            "fax_number": "239-687-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FQ0014",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "BARTRUFF",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-687-3275"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fitness Quest Gateway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.