Individual provider Active NPI

Robert Poliszuk, DPT

  • Physical Therapist
  • Coral Gables, FL
National Provider Identifier
1518489574
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32695 Issued in FL
Practice address
1500 S Douglas Rd Ste 210
Coral Gables, FL 33134-4108
Phone
(305) 448-0146
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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 PT32695 FL Primary

Addresses

Primary practice location

1500 S Douglas Rd Ste 210
Coral Gables, FL 33134-4108

Mailing address

185 SE 14TH Ter Apt 906
Miami, FL 33131-3415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190517001948 FL Practitioner - Physical Therapist in Private Practice 0244593689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiologix Sports Physical Therapy PLLCGroup PAC ID 8123361904, 2 clinicians

Practice addresses (Care Compare)

9531 NE 2ND Ave
Suite 101
Miami Shores, FL 33138-2704
Phone (305) 902-6644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT32695FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiologix Sports Physical Therapy PLLC Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Physiologix Sports Physical Therapy LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

1625 N Miami Ave
Ste 101
Miami, FL 33136
Phone (305) 902-6644

9531 NE 2nd Ave
Ste 101
Miami Shores, FL 33138
Phone (305) 902-6644

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.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1518489574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SE 14TH TER APT 906",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 210",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "305-448-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISZUK",
        "first_name": "ROBERT",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2017; 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.