Keith Ryan Madonia, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19334 Issued in FL

Practice address

2042 SW Providence PL
Port St Lucie, FL 34953-4385

Phone

(305) 310-3702

Fax

(888) 293-8662

NPI assigned

May 10, 2006

Last updated

May 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Keith R. Madonia, P.a.

  dba Optimum Physical Therapy

  • Physical Therapist
  • Port St Lucie, FL
  • NPI 1417352485
  Authorized official Same address or phone

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1740239250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 SW PROVIDENCE PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534385",
            "telephone_number": "305-310-3702",
            "fax_number": "888-293-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 SW PROVIDENCE PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534385",
            "telephone_number": "305-310-3702",
            "fax_number": "888-293-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONIA",
        "first_name": "KEITH",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Y056RY",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Louise Macdougall, APRN, FNP-BC
• Omar Agustin Machado Franco
• Ana Paula Machado-Hopkins, M.D.
• Macmillan Paul and Burkarth PA (treasure coast neurosurgery)
• Madigan Family LLC (Madigan Family Health Center)
• Tatiana C Madonia, PT
• Cecelia Mary Magaw
• Magda Care Services LLC
• Mahant Pharmacy Inc (Floresta Pharmacy ( S & CP ))
• Mahant Pharmacy Inc (Floresta Pharmacy)

• Physical Therapist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.