Individual provider Active NPI

Samantha Nivison

  • Physical Therapist
  • Bradenton, FL
National Provider Identifier
1710718200
Registry record updated Jul 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42053 Issued in FL
Practice address
104 53Rd Ave E
Bradenton, FL 34203-4702
Phone
(941) 925-2700
Fax
(941) 925-7744
NPI assigned
Aug 8, 2024
Last updated
Jul 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2025

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 PT42053 FL Primary

Addresses

Primary practice location

104 53Rd Ave E
Bradenton, FL 34203-4702

Mailing address

5525 1St Ave E Apt 203
Bradenton, FL 34208-6098
Phone (407) 967-0660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910000864 FL Practitioner - Physical Therapist in Private Practice 5092255638 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Motion Sarasota Physical Therapy PLGroup PAC ID 2466465075, 6 clinicians

Practice addresses (Care Compare)

104 53Rd Ave E
Bradenton, FL 34203-4702
Phone (941) 925-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Sarasota Physical Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
European Physical Therapy LC Physical Therapist CurrentSince Aug 8, 2024 Accepting new patients

Locations

104 53rd Ave E
Bradenton, FL 34203
Phone (941) 465-3740

3920 Bee Ridge Rd
Ste E-G
Sarasota, FL 34233
Phone (941) 925-2700

6000 Cattleridge Dr
Ste 100
Sarasota, FL 34232
Phone (941) 378-8977

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": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1710718200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 1ST AVE E APT 203",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342086098",
            "telephone_number": "407-967-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 53RD AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034702",
            "telephone_number": "941-925-2700",
            "fax_number": "941-925-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIVISON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2025-07-13",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2025; 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.