Individual provider Active NPI

Dexter Penaranda

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1518164698
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5820 Harborage Dr
Fort Myers, FL 33908-4549
Phone
(239) 462-2278
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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 Primary

Addresses

Primary practice location

5820 Harborage Dr
Fort Myers, FL 33908-4549

Mailing address

5820 Harborage Dr
Fort Myers, FL 33908-4549

Other identifiers 1

IdentifierTypeStateIssuer
19144OtherFLLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161115001416 FL Practitioner - Physical Therapist in Private Practice 0749453587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness by Physicians IncGroup PAC ID 4688966260, 10 clinicians

Practice addresses (Care Compare)

6150 Diamond Centre CT
BLDG 100
Fort Myers, FL 33912-4367
Phone (239) 768-6396

773 Hwy 466
Lady Lake, FL 32159-6340
Phone (239) 768-6396

Merit-based Incentive Payment System (MIPS)

Final score
60.29 of 100Reported as group
Quality
35.5
Improvement activities
40
Cost
53.62

Merit-based Incentive Payment System (MIPS)

Final score
64.42 of 100Reported as group
Quality
38.39
Improvement activities
40
Cost
63.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness by Physicians, Inc. Physical Therapist CurrentSince Sep 1, 2016 Accepting new patients
Wellness by Physicians, Inc. Physical Therapist CurrentSince Sep 1, 2016 Accepting new patients
Physicians for Quality Healthcare, Inc. CurrentSince Oct 20, 2011 Accepting new patients

Locations

24870 S Tamiami Trl
Ste 3
Bonita Springs, FL 34134
Phone (239) 676-3663

3321 Del Prado Blvd S
Ste 3
Cape Coral, FL 33904
Phone (239) 230-2490

6150 Diamond Centre Ct
Bldg 100
Fort Myers, FL 33912
Phone (239) 768-6896

12090 Metro Pkwy
Fort Myers, FL 33966

773 Highway 466
Lady Lake, FL 32159
Phone (321) 274-1864

733 Highway 466
Lady Lake, FL 32159
Phone (352) 205-7702

5668 Strand Ct
Naples, FL 34110
Phone (239) 590-3883

3417 Tamiami Trl
Ste A
Pt Charlotte, FL 33952
Phone (941) 344-9249

Organizations & group practices 3

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1518164698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 HARBORAGE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 HARBORAGE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084549",
            "telephone_number": "239-462-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENARANDA",
        "first_name": "DEXTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "19144",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.