Jedryk Alan Codamon Quitzon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1580 Sawgrass Corporate Pkwy Ste 200
Sunrise, FL 33323-2869

Phone

(954) 296-4748

NPI assigned

Jul 7, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samasta Services IncGroup PAC ID 9133341092, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Samasta Services Inc

  dba Tri-City Physical Therapy

  • Physical Therapist
  • Union City, CA
  • NPI 1124427430
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530921600000",
    "number": "1558857029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "954-296-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "954-296-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUITZON",
        "first_name": "JEDRYK ALAN",
        "middle_name": "CODAMON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-07",
        "last_updated": "2018-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Questcare Phcy LLC (Questcare Pharmacy)
• Quick Stop Transportation Services LLC
• Amanda S Quilichini Antoni, PHARM D
• Olivia Patricia Quintero, MS
• Crispin Quismundo
• R Dale Enterprises Inc
• Jorge Rabinovich, PA-C
• Carly Rachman, D.O.M, A.P.
• Julius Racho, PT
• Jenna Radecsky, PHARM.D.

• Physical Therapist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; 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.