Individual provider Active NPI

David Michael Phillips, MPT

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1497719470
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19912 Issued in FL
Practice address
1905 Clint Moore Rd
Suite 214
Boca Raton, FL 33496-2658
Phone
(561) 241-8668
Fax
(561) 912-9556
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 19912 FL Primary

Addresses

Primary practice location

1905 Clint Moore Rd
Suite 214
Boca Raton, FL 33496-2658

Mailing address

5621 American Cir
Delray Beach, FL 33484-8566
Phone (954) 401-6152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000785 FL Practitioner - Physical Therapist in Private Practice 6608907340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19912FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brent C Stuart LLC Physical Therapist CurrentSince Feb 23, 2026 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1497719470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5621 AMERICAN CIR",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334848566",
            "telephone_number": "954-401-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 CLINT MOORE RD",
            "address_2": "SUITE 214",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962658",
            "telephone_number": "561-241-8668",
            "fax_number": "561-912-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "19912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.