Individual provider Active NPI

Benson P Bagasan, PT

  • Physical Therapist
  • Greenacres, FL
National Provider Identifier
1700815438
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8860 Issued in FL
Practice address
2746 Pointe Cir
Greenacres, FL 33413-2153
Phone
(561) 308-1370
Fax
(561) 469-2181
NPI assigned
Jul 3, 2006
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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 8860 FL Primary

Addresses

Primary practice location

2746 Pointe Cir
Greenacres, FL 33413-2153

Mailing address

2746 Pointe Cir
Greenacres, FL 33413-2153
Phone (561) 308-1370

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051207000455 FL Practitioner - Physical Therapist in Private Practice 8921029810 Practice locations: Greenacres, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8860FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Physical Therapy and Rehab, Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1700815438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 POINTE CIR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334132153",
            "telephone_number": "561-308-1370",
            "fax_number": "561-469-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 POINTE CIR",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334132153",
            "telephone_number": "561-308-1370",
            "fax_number": "561-469-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGASAN",
        "first_name": "BENSON",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "8860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.