Jude A Wagnac, DPT, ATC/L

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 29266 Issued in FL

Practice address

2950 Cleveland Clinic Blvd
Weston, FL 33331-3609

Phone

(954) 659-5370

NPI assigned

Dec 9, 2010

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 FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tphysical266684@direct.ccf.org

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment NPD
• Go-PT Inc.

  • Physical Therapist
  • Jupiter, FL
  • NPI 1295518553
  Medicare reassignment NPD
• Sobe Innovative Rehabilitation PLLC

  • Physical Therapist
  • Miami, FL
  • NPI 1164800595
  Medicare reassignment NPD
• Therapy Care Rehab, Inc.

  • Geriatric Physical Therapist
  • Pembroke Pines, FL
  • NPI 1780325092
  Medicare reassignment NPD
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1679876817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7353 NW 174TH TER APT 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330151135",
            "telephone_number": "786-512-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 CLEVELAND CLINIC BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313609",
            "telephone_number": "954-659-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNAC",
        "first_name": "JUDE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT, ATC/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-09",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 29266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Estefania Vitti
• Rachany Vongkhamphra Brown, MS CCC SLP
• Sabrina C Vullo, DNP APRN FNP-BC
• Hara Wachholder, MS, LMHC
• Dianne K Wade Cooper, AU.D.
• Alexandra Wagner
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Sherrie Walker, RD, LDN, CNSC

• Physical Therapist in Weston, FL
• Providers in Weston, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; 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.