Farese Physical Therapy Center, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT4310 Issued in FL

Legal business name

FARESE PHYSICAL THERAPY CENTER, INC

Practice address

7005 Fourth Street North
Suite 4
St Petersburg, FL 33702

Phone

(727) 209-4545

Fax

(727) 209-4546

NPI assigned

May 2, 2006

Last updated

Feb 23, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Patricia Lee Farese, MHS, MBA, PT, CHTNPI 1053453845

Title

Vice President

Phone

(727) 209-4545

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710945704. Details of each certification follow.

• CCN 106792 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 106792

Legal name

FARESE PHYSICAL THERAPY CENTER

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 26, 1992

Last certification

May 24, 2022

Ownership / control type

Proprietary

Facility address

7005 4TH St N, Ste 4
Saint Petersburg, FL 33702

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Farese Physical Therapy Center, Inc.

  • Physical Therapist
  • St Petersburg, FL
  • NPI 1194932426

  O20031118000185

  Same enrollment
• Farese Physical Therapy, Inc

  • Physical Therapist
  • Largo, FL
  • NPI 1912115825

  O20031118000185

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia L Farese, PT

  • Physical Therapist
  • St Petersburg, FL
  • NPI 1053453845
  Authorized official Same address or phone

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1710945704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7005 FOURTH STREET NORTH",
            "address_2": "SUITE 4",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-209-4545",
            "fax_number": "727-209-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 FOURTH STREET NORTH",
            "address_2": "SUITE 4",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-209-4545",
            "fax_number": "727-209-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARESE PHYSICAL THERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "FARESE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "727-209-4545",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHS, MBA, PT, CHT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886130700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fana Medical Group PA
• Miguel Antonio Fana Jr., M.D.
• Jill M Fandrich, PHARM D
• Carina Farag
• Abdeen Rihan Farah Musa, MBBS
• Farese Physical Therapy Center, Inc.
• Patricia L Farese, PT
• Aghapy Farhan, MA, BCBA
• Farkas Chiropractic Clinic PA
• Brian Farkas, D.C.

• Physical Therapy Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.