Individual provider Active NPI

Wonmi Lussier, DPT

  • Physical Therapist
  • Plantation, FL
National Provider Identifier
1548714686
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
31508 Issued in FL
Practice address
600 S Pine Island Rd
Plantation, FL 33324-3166
Phone
(954) 474-2525
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT31508
Physical Therapist 225100000X 31508 FL Primary

Addresses

Primary practice location

600 S Pine Island Rd
Plantation, FL 33324-3166

Mailing address

956 Mockingbird LN Apt 504
Plantation, FL 33324-3441
Phone (708) 662-0379

Other names 1

  • Wonmi Yoo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220714002758 FL Practitioner - Physical Therapist in Private Practice 5991186496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
She Physical Therapy, LLCGroup PAC ID 2163840273, 4 clinicians

Practice addresses (Care Compare)

10220 W State Rd
84 Suite 5
Davie, FL 33324-4223
Phone (954) 406-8998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31508FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
She Physical Therapy, LLC Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Jul 11, 2022 Accepting new patients

Locations

10220 W State Road 84
Ste 5
Davie, FL 33324
Phone (954) 382-0001

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

Networks

  • Optimum HealthCare HMO Network

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": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1548714686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 MOCKINGBIRD LN APT 504",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243441",
            "telephone_number": "708-662-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PINE ISLAND RD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243166",
            "telephone_number": "954-474-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSSIER",
        "first_name": "WONMI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "PT31508",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WONMI",
            "last_name": "YOO",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.