Individual provider Active NPI

Diane Cheryl Grusky, PT

  • Physical Therapist
  • Parkland, FL
National Provider Identifier
1477607869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12159 Issued in FL
Practice address
11272 NW 71St CT
Parkland, FL 33076-3866
Phone
(954) 415-3892
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT12159 FL Primary

Addresses

Primary practice location

11272 NW 71St CT
Parkland, FL 33076-3866

Mailing address

11272 NW 71St CT
Parkland, FL 33076-3866
Phone (954) 415-3892

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013001204 FL Practitioner - Physical Therapist in Private Practice 8628038775 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT12159FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In Home Physical Therapy Physical Therapist CurrentSince Oct 28, 2004 Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients
Physical Therapy in Your Home Inc Past Accepting new patients
Complete Rehab Solutions, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477607869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11272 NW 71ST CT",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330763866",
            "telephone_number": "954-415-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11272 NW 71ST CT",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330763866",
            "telephone_number": "954-415-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSKY",
        "first_name": "DIANE",
        "middle_name": "CHERYL",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.