Individual provider Active NPI

Karen Pronko

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1477093292
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21348 Issued in FL
Practice address
4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone
(850) 494-0000
Fax
(850) 494-0001
NPI assigned
Feb 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 21348 FL Primary

Addresses

Primary practice location

4624 N Davis Hwy
Pensacola, FL 32503-2337

Mailing address

4624 N Davis Hwy
Pensacola, FL 32503-2337
Phone (850) 494-0000

Other practice location 1

10100 Hillview Dr
Pensacola, FL 32514-5436
Phone (850) 378-3374

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@pcofwfla.e-mdsdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428000833 FL Practitioner - Physical Therapist in Private Practice 5294012266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Texas Medical Branch at Galveston, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

3964 Florida Ave
Jay, FL 32565-1104
Phone (850) 741-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21348FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Consultants of West Florida CurrentSince Apr 11, 2021 Accepting new patients

Locations

4624 N Davis Hwy
Pensacola, FL 32503
Phone 85049400002014

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": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1477093292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032337",
            "telephone_number": "850-494-0000",
            "fax_number": "850-494-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10100 Hillview Dr",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325145436",
            "country_code": "US",
            "telephone_number": "850-378-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRONKO",
        "first_name": "KAREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "21348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@pcofwfla.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "4624 N Davis Hwy",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325032337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.