Individual provider Active NPI

Brett James Perera, DPT

  • Physical Therapist
  • Lake Worth, FL
National Provider Identifier
1689961682
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26497 Issued in FL
Practice address
6169 S Jog Rd Ste A11
Lake Worth, FL 33467-6586
Phone
(561) 432-0111
Fax
(561) 432-1075
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 PT26497 FL Primary

Addresses

Primary practice location

6169 S Jog Rd Ste A11
Lake Worth, FL 33467-6586

Mailing address

5840 Corporate Way Ste 101
West Palm Beach, FL 33407-2040
Phone (561) 432-0111

Other identifiers 1

IdentifierTypeStateIssuer
004004700MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908001892 FL Practitioner - Physical Therapist in Private Practice 4789854399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11482 Okeechobee Blvd
Suite 2
Royal Palm Beach, FL 33411-8735
Phone (561) 432-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26497FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Coast Physical Therapy Associates LLC Physical Therapist Current Accepting new patients
Gold Coast Physical Therapy Associates LLC CurrentSince Jul 5, 2011 Accepting new patients
Gold Coast Physical Therapy Associates LLC CurrentSince Jul 5, 2011 Accepting new patients

Locations

23172 Sandalfoot Plaza Dr
Boca Raton, FL 33428

6169 S Jog Rd
Ste A11
Lake Worth, FL 33467
Phone (561) 331-3636

11482 Okeechobee Blvd
Ste 2
Royal Palm Beach, FL 33411

9897 Lake Worth Rd
Ste 203
Wellington, FL 33467
Phone (561) 242-0665

5840 Corporate Way
Ste 101
West Palm Beach, FL 33407
Phone (561) 852-7352

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1689961682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 CORPORATE WAY STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072040",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6169 S JOG RD STE A11",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676586",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERERA",
        "first_name": "BRETT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004004700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.