Individual provider Active NPI

Patricia MC Cormick, PT

  • Physical Therapist
  • Winter Garden, FL
National Provider Identifier
1730954603
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40456 Issued in FL
Practice address
16131 Hampton Crossing Dr
Winter Garden, FL 34787-9261
Phone
(321) 609-8870
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 PT40456 FL Primary

Addresses

Primary practice location

16131 Hampton Crossing Dr
Winter Garden, FL 34787-9261

Mailing address

1136 Via Galuppi St
Poinciana, FL 34759-3942

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231204003518 FL Practitioner - Physical Therapist in Private Practice 7113375957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Physical Therapy and Wellness LLCGroup PAC ID 1153727169, 5 clinicians

Practice addresses (Care Compare)

Winter Garden, FL 34787
Phone (845) 545-7778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40456FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physical Therapy and Wellness LLC Physical Therapist CurrentSince Nov 21, 2023 Accepting new patients
Stern at Home Physical Therapy PC Physical Therapist PastSince Nov 21, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1730954603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 VIA GALUPPI ST",
            "city": "POINCIANA",
            "state": "FL",
            "postal_code": "347593942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16131 HAMPTON CROSSING DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347879261",
            "telephone_number": "321-609-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC CORMICK",
        "first_name": "PATRICIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.