Individual provider Active NPI

Alvin A Ponce de Leon, P.T.

  • Physical Therapist
  • Jupiter, FL
National Provider Identifier
1679744064
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
175 Toney Penna Dr
Suite 206a
Jupiter, FL 33458-5755
Phone
(561) 746-8148
NPI assigned
Mar 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

175 Toney Penna Dr
Suite 206a
Jupiter, FL 33458-5755

Mailing address

175 Toney Penna Dr
Suite 206a
Jupiter, FL 33458-5755
Phone (561) 281-6537

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080515000288 FL Practitioner - Physical Therapist in Private Practice 5092884106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

275 Toney Penna Dr
Suite 12
Jupiter, FL 33458-5752
Phone (561) 746-8148

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifemotion Physical Therapy Inc Physical Therapist CurrentSince Mar 22, 2010 Accepting new patients

Locations

175 Toney Penna Dr
Ste 206A
Jupiter, FL 33458
Phone (561) 746-8148

275 Toney Penna Dr
Ste 12
Jupiter, FL 33458
Phone (561) 575-2225

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": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1679744064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 TONEY PENNA DR",
            "address_2": "SUITE 206A",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585755",
            "telephone_number": "561-281-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 TONEY PENNA DR",
            "address_2": "SUITE 206A",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585755",
            "telephone_number": "561-746-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE DE LEON",
        "first_name": "ALVIN",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.