Individual provider Active NPI

Joseph C Reilly, P.T.

  • Physical Therapist
  • Venice, FL
National Provider Identifier
1669414694
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14970 Issued in FL
Practice address
4119 Tamiami TRL S
Venice, FL 34293-5109
Phone
(941) 408-8800
Fax
(941) 408-0255
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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 PT14970 FL Primary

Addresses

Primary practice location

4119 Tamiami TRL S
Venice, FL 34293-5109

Mailing address

1954 Tamiami TRL S
Venice, FL 34293-5001
Phone (941) 408-8800

Other identifiers 2

IdentifierTypeStateIssuer
Y8941OtherFLBCBS OF FL
650019630OtherFLRAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120719000209 FL Practitioner - Physical Therapist in Private Practice 4486816402 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians

Practice addresses (Care Compare)

400 Tamiami TRL S
Suite 210
Venice, FL 34285-2626
Phone 87746937782004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14970FLMDDentist
PT14970FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fitness Quest-Port Charlotte LLC Physical Therapist CurrentSince Jan 16, 2023 Accepting new patients
Fitness Quest - Venice LLC CurrentSince Jan 16, 2022 Accepting new patients
Fitness Quest - Venice LLC Physical Therapist CurrentSince Jan 16, 2022 Accepting new patients
Fitness Quest - Palmer Ranch, LLC Physical Therapist CurrentSince Jan 16, 2023 Accepting new patients
Fitness Quest - Bradenton LLC CurrentSince Jan 16, 2023 Accepting new patients
Fitness Quest West Villages, LLC CurrentSince Jan 16, 2023 Accepting new patients

Locations

3657 Cortez Rd W
Ste 110
Bradenton, FL 34210
Phone (941) 361-9020

2828 S McCall Rd
Ste 25
Englewood, FL 34224
Phone (941) 460-6174

11045 Tamiami Trl S
North Port, FL 34287
Phone (877) 469-3778

3479 Precision Dr
Ste 115
North Venice, FL 34275
Phone (941) 275-6377

1649 Tamiami Trl
Ste 1A
Pt Charlotte, FL 33948
Phone (941) 743-6700

8588 Potter Park Dr
Ste 201
Sarasota, FL 34238
Phone (941) 361-9020

400 Tamiami Trl S
Ste 210
Venice, FL 34285
Phone (877) 469-3778

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 6

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1669414694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935001",
            "telephone_number": "941-408-8800",
            "fax_number": "941-408-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935109",
            "telephone_number": "941-408-8800",
            "fax_number": "941-408-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JOSEPH",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "Y8941",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "650019630",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.