Kennedy Day
Individual provider Active NPI Physical Therapist · Trinity, FL
NPI 1497439376 · NPPES record last updated Jun 12, 2023
Key facts
- NPI
- 1497439376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTT40288 (FL)
- Practice address
- 11157 Trinity Blvd
Trinity, FL 34655-4538 - Phone
- (727) 645-4120
- NPI assigned
- Jun 12, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optimal Performance and Physical Therapies Trinity LLC
Practice addresses (Care Compare)
11157 Trinity Blvd
Trinity, FL 34655-4538
Phone (727) 645-4120
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830001846 | FL | Practitioner - Physical Therapist in Private Practice | 3072976687 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTT40288 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimal Performance and Physical Therapies Trinity LLC | Physical Therapist | Current |
Accepting new patients |
Locations
21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234
11157 Trinity Blvd
Trinity, FL 34655
Phone (727) 645-4120
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTT40288 | FL | Yes |
Addresses
Primary practice location
11157 Trinity Blvd
Trinity, FL 34655-4538
Mailing address
21756 State Road 54 Ste 102
Lutz, FL 33549-2905
Other providers in Trinity, FL
- Darlene Starrett G Darlene Starrett
- David Payne & Associates, LLC
- Alfredo Davila-Rivera
- Alexander R Davis
- Shana Suzanne Davis
- Shailja Thawani Dayal
- Chase Decubellis
- Jon-Michael Degidio
- Kelle Christine Degroat
- Giovanni Dejesus
All providers in Trinity, FL · Physical Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.