Individual provider Active NPI

Jessica Novoa, DPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1699351882
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
12030 SW 129TH CT Ste 108
Miami, FL 33186-4584
Phone
(305) 432-4032
NPI assigned
Mar 19, 2021
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 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 NU Primary

Addresses

Primary practice location

12030 SW 129TH CT Ste 108
Miami, FL 33186-4584

Mailing address

12030 SW 129TH CT Ste 107
Miami, FL 33186-4584
Phone (305) 432-4032

Other names 1

  • Jessica Lopez Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210510000620 FL Practitioner - Physical Therapist in Private Practice 6608285499 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Kids Therapy LLC CurrentSince May 7, 2024 Accepting new patients
Little Lamb ABA Therapy Current Accepting new patients
C&C PT LLC Physical Therapist CurrentSince Apr 20, 2025 Accepting new patients
San Miguel Community Wellness Center PastSince Apr 1, 2023 Accepting new patients

Locations

12030 SW 129th Ct
Ste 108
Miami, FL 33186
Phone (305) 432-4032

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, 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": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1699351882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 SW 129TH CT STE 107",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864584",
            "telephone_number": "305-432-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 SW 129TH CT STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864584",
            "telephone_number": "305-432-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOA",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LOPEZ",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.