Active NPI
Homer Busi Pique
- Physical Therapy Assistant
- Coral Spring, FL
National Provider Identifier
1477083160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2128459
- Practice address
- 12272 West Sample Road
Coral Spring, FL 33065 - Phone
- (571) 215-6850
- NPI assigned
- Jun 14, 2017
- 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 Therapy Assistant | 225200000X | 2128459 | TX | Primary |
Addresses
Primary practice location
12272 West Sample Road
Coral Spring, FL 33065
Mailing address
12272 W Sample Rd
Coral Springs, FL 33065-4227
Phone (571) 215-6850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2128459 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477083160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12272 W SAMPLE RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330654227",
"telephone_number": "571-215-6850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12272 WEST SAMPLE ROAD",
"city": "CORAL SPRING",
"state": "FL",
"postal_code": "33065",
"telephone_number": "571-215-6850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIQUE",
"first_name": "HOMER",
"middle_name": "BUSI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2128459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Spring, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.