Individual provider Active NPI

Zachary Bordeau

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1639808561
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437
Phone
(561) 504-2106
NPI assigned
Jun 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 Primary

Addresses

Primary practice location

3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437

Mailing address

3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437
Phone (561) 504-2106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220711000257 FL Practitioner - Physical Therapist in Private Practice 4082094800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Van Pelt & Associates Physical Therapy Services PA Physical Therapist CurrentSince May 20, 2022 Accepting new patients

Locations

3848 Fau Blvd
Ste 105
Boca Raton, FL 33431
Phone (561) 395-2920

Organizations & group practices 1

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1639808561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-504-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-504-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEAU",
        "first_name": "ZACHARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.