Individual provider Active NPI

Anna H. Resnick, PT

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1740449107
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9978 Issued in MA
Practice address
812 Glouchester St
Boca Raton, FL 33487-3212
Phone
(305) 934-7498
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9978 MA Primary
Physical Therapist 225100000X PT23964 FL

Addresses

Primary practice location

812 Glouchester St
Boca Raton, FL 33487-3212

Mailing address

812 Glouchester St
Boca Raton, FL 33487-3212
Phone (305) 934-7498

Other identifiers 2

IdentifierTypeStateIssuer
0721026MedicaidMA
001528900MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090305000365 MA Practitioner - Physical Therapist in Private Practice 3870585896 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT23964FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medpro Home Care Solutions, LLC Current Accepting new patients
Metropolitan Home Care LLC PastSince Nov 15, 2013 Accepting new patients
RMG Home Care, Inc PastSince Feb 25, 2014 Accepting new patients
South Florida Pain Clinic, LLC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medpro Home Care Solutions LLCSalem, MA, CCN 227800 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1740449107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 GLOUCHESTER ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873212",
            "telephone_number": "305-934-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 GLOUCHESTER ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873212",
            "telephone_number": "305-934-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "ANNA",
        "middle_name": "H.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "9978",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23964",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0721026",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001528900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.