Individual provider Active NPI

Sebastian Osorio, PT

  • Physical Therapist
  • Plantation, FL
National Provider Identifier
1710712633
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42279 Issued in FL
Practice address
350 NW 70TH Ave Ste a
Plantation, FL 33317-2349
Phone
(954) 741-2221
Fax
(954) 741-2155
NPI assigned
Sep 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 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 PT42279 FL Primary

Addresses

Primary practice location

350 NW 70TH Ave Ste a
Plantation, FL 33317-2349

Mailing address

430 Commodore Dr Apt 104
Plantation, FL 33325-2134
Phone (954) 470-0575

Other practice location 1

6471 W Commercial Blvd
Tamarac, FL 33319-2110
Phone (954) 741-2221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912004540 FL Practitioner - Physical Therapist in Private Practice 9032659313

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

350 NW 70TH Ave
Suite a
Plantation, FL 33317-2349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42279FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabxperience LLC CurrentSince Sep 3, 2024 Accepting new patients

Locations

350 NW 70th Ave
#A
Plantation, FL 33317
Phone (954) 587-7520

6471 W Commercial Blvd
Tamarac, FL 33319
Phone (954) 741-2221

Organizations & group practices 1

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": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1710712633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 COMMODORE DR APT 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333252134",
            "telephone_number": "954-470-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NW 70TH AVE STE A",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172349",
            "telephone_number": "954-741-2221",
            "fax_number": "954-741-2155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6471 W Commercial Blvd",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "333192110",
            "country_code": "US",
            "telephone_number": "954-741-2221",
            "fax_number": "954-741-2155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "SEBASTIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.