Individual provider Active NPI

Douglas Fiorentino, DPT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1578344875
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34023 Issued in FL
Practice address
105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251
Phone
(904) 217-4259
Fax
(904) 217-4251
NPI assigned
Oct 12, 2023
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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 PT34023 FL Primary

Addresses

Primary practice location

105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251

Mailing address

105 Mariner Health Way Ste 213
Saint Augustine, FL 32086-3251
Phone (904) 217-4259

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260506000432 FL Practitioner - Physical Therapist in Private Practice 7315415569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

105 Mariner Health Way
Suite 213
St Augustine, FL 32086-3251
Phone (904) 217-4259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT34023FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Orthopedic Specialists, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1578344875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORENTINO",
        "first_name": "DOUGLAS",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.