Individual provider Active NPI

Robert Zicchino, MPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1528105244
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20576 Issued in FL
Practice address
2727 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6383
Phone
(813) 348-9688
Fax
(813) 348-9687
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT20576 FL Primary

Addresses

Primary practice location

2727 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6383

Mailing address

24240 Summer Wind CT
Lutz, FL 33559-7926
Phone (813) 909-7441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806003213 FL Practitioner - Physical Therapist in Private Practice 1557427960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports and Orthopedic Rehabilitation Services, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Sports and Orthopedic Rehabilitation Services, Inc. Current Accepting new patients
Sports and Orthopedic Rehabilitation Services Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

1938 Highland Oaks Blvd
Lutz, FL 33559
Phone (813) 738-9093

5347 Main St
Ste 202
New Prt Rchy, FL 34652
Phone (727) 841-0515

13133 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 515-3370

15310 Amberly Dr
Ste 155
Tampa, FL 33647
Phone (727) 777-2705

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528105244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24240 SUMMER WIND CT",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597926",
            "telephone_number": "813-909-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076383",
            "telephone_number": "813-348-9688",
            "fax_number": "813-348-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZICCHINO",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20576",
            "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 Jul 8, 2007; 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.