Active NPI
Jerrold Ofiana, DPT
- Physical Therapist
- Melbourne, FL
National Provider Identifier
1487293015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT37705
- 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, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT37705 | FL | MD | Physical Therapist |
| 070024905 | IL | MD | Physical Therapist |
| 13654 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevate Home Rehab Inc | Physical Therapist | Current | 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.
-
- Physical Therapist
- Melbourne, FL
- NPI 1083465769
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.