Individual provider Active NPI

Jerrold Ofiana, DPT

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1487293015
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37705 Issued in FL
Practice address
2735 Vuldarno LN
Melbourne, FL 32940-7695
Phone
(513) 504-7911
Fax
(866) 337-2549
NPI assigned
Dec 30, 2019
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070024905 IL
Physical Therapist 225100000X PT37705 FL Primary

Addresses

Primary practice location

2735 Vuldarno LN
Melbourne, FL 32940-7695

Mailing address

109 Rosewood Dr
Streamwood, IL 60107-1581

Other practice location 1

220 N Smith St Ste 100
Palatine, IL 60067-2415
Phone (847) 934-7330

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT37705FLMDPhysical Therapist
070024905ILMDPhysical Therapist
13654TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Home Rehab Inc Physical Therapist CurrentSince Mar 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1487293015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 ROSEWOOD DR",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601071581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 VULDARNO LN",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407695",
            "telephone_number": "513-504-7911",
            "fax_number": "866-337-2549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N Smith St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Palatine",
            "state": "IL",
            "postal_code": "600672415",
            "country_code": "US",
            "telephone_number": "847-934-7330",
            "fax_number": "847-394-7579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OFIANA",
        "first_name": "JERROLD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-30",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024905",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.

Verify at the official NPI Registry.