NPIMap

Organization Active NPI

Optimal Performance and Physical Therapies University LLC

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1497079388
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES UNIVERSITY LLC
Practice address
3010 E 138TH Ave Ste 1
Tampa, FL 33613-3902
Phone
(813) 805-8102
Fax
(844) 757-3729
NPI assigned
Mar 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Authorized official

Name
Beth A PattersonNPI 1215051776
Title
Chief of Compliance
Phone
(813) 690-4414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3010 E 138TH Ave Ste 1
Tampa, FL 33613-3902

Mailing address

21756 State Road 54 Ste 102
Lutz, FL 33549-2905
Phone (727) 475-5540

Other practice location 1

3450 E Fletcher Ave
Suite 130
Tampa, FL 33613-4655
Phone (813) 690-4494

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100602000176 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7517096431 Receives reassigned benefits from 9 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1497079388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54 STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "727-475-5540",
            "fax_number": "844-927-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E 138TH AVE STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133902",
            "telephone_number": "813-805-8102",
            "fax_number": "844-757-3729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 E Fletcher Ave",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336134655",
            "country_code": "US",
            "telephone_number": "813-690-4494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES UNIVERSITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-21",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OF COMPLIANCE",
        "authorized_official_telephone_number": "813-690-4414"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.