Allan Francis Supremo Santoalla

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860

Phone

(954) 684-7054

NPI assigned

Dec 21, 2011

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 NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645
  Medicare reassignment Care Compare group NPD
• Medpro Healthcare Staffing

  • Rehabilitation Hospital
  • Sunrise, FL
  • NPI 1922342021
  NPD (past)

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1629347562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232860",
            "telephone_number": "954-684-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232860",
            "telephone_number": "954-684-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOALLA",
        "first_name": "ALLAN FRANCIS",
        "middle_name": "SUPREMO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Santi, BCBA
• Ileana Gretell Santiago
• Viviana Santiago
• Yumaris Santiesteban, APRN
• Karla Santis, DPT
• Maria Cristina Santos, RRT
• Roselle Padilla Santos
• Maria M Sarach-Kozlowska, MD
• Wendy Saravia, MSW
• Kathryn Ann Tomines Sarmiento, P.T.

• 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 Dec 21, 2011; 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.