Individual provider Active NPI

Daniel Obradovich, DPT

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1487933727
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26645 Issued in FL
Practice address
3260 N Harbor City Blvd
Melbourne, FL 32935-6203
Phone
(321) 693-8196
Fax
(321) 373-4007
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
Yes

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Align Physical Therapy, Inc 9 clinicians

Practice addresses (Care Compare)

2030 S Patrick Dr
Suite 3
Indian Harbour Beach, FL 32937-4400
Phone (321) 622-5707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613003585 FL Practitioner - Physical Therapist in Private Practice 7214395805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26645FLMDPhysical Therapist

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Align Physical Therapy, Inc. Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Align Physical Therapy, Inc. Physical Therapist PastSince Mar 17, 2024 Accepting new patients

Locations

2030 South Patrick Dr
Ste 3
Indian Harbour Beach, FL 32937
Phone (321) 622-5707

Networks

  • Freedom Health HMO Network

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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 PT26645 FL Primary

Addresses

Primary practice location

3260 N Harbor City Blvd
Melbourne, FL 32935-6203

Mailing address

3260 N Harbor City Blvd
Melbourne, FL 32935-6203
Phone (321) 693-8196

NPI Registry JSON

The complete record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1487933727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 N HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356203",
            "telephone_number": "321-693-8196",
            "fax_number": "321-373-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 N HARBOR CITY BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356203",
            "telephone_number": "321-693-8196",
            "fax_number": "321-373-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRADOVICH",
        "first_name": "DANIEL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26645",
            "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 Apr 23, 2018; 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.