Individual provider Active NPI

Nicholas Palumbo, PT

  • Physical Therapist
  • Summerfield, FL
National Provider Identifier
1730879107
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40150 Issued in FL
Practice address
17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015
Phone
(352) 336-6000
NPI assigned
May 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 PT40150 FL Primary

Addresses

Primary practice location

17270 SE 109TH Terrace Rd
Summerfield, FL 34491-9015

Mailing address

4500 Newberry Rd
Gainesville, FL 32607-2245
Phone (352) 336-0000

Other names 1

  • Nick Palumbo Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531003600 FL Practitioner - Physical Therapist in Private Practice 5496112781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40150FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Institute PA CurrentSince May 1, 2023 Accepting new patients
The Orthopaedic Institute, PA CurrentSince May 1, 2023 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

146 SW Orthopedic Ct
Lake City, FL 32024
Phone (386) 755-9215

17270 SE 109th Terrace Rd
Summerfield, FL 34491
Phone (352) 336-0000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1730879107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072245",
            "telephone_number": "352-336-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17270 SE 109TH TERRACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344919015",
            "telephone_number": "352-336-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "NICHOLAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "PALUMBO",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Summerfield, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.