Individual provider Active NPI

Ma. Paulynne Grace Tumambing Llaguno, PT, DPT

  • Physical Therapist
  • Sunrise, FL
National Provider Identifier
1699515684
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12608 Issued in CT
Practice address
1580 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2869
Phone
(626) 642-1894
NPI assigned
May 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 12608 CT Primary

Addresses

Primary practice location

1580 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2869

Mailing address

1580 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240816001828 OR Practitioner - Physical Therapist in Private Practice 8729526140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Oregon LLCGroup PAC ID 0143510602, 124 clinicians

Practice addresses (Care Compare)

300 Glen Creek Rd NW
Salem, OR 97304-3058
Phone (503) 990-8627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist Current Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

300 Glen Creek Rd NW
Salem, OR 97304
Phone (503) 990-8627

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1699515684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "626-642-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLAGUNO",
        "first_name": "MA. PAULYNNE GRACE",
        "middle_name": "TUMAMBING",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.