Individual provider Active NPI

Andrea Gabriela Castro, DPT

  • Physical Therapist
  • Port Saint Lucie, FL
National Provider Identifier
1740970532
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40155 Issued in FL
Practice address
10198 SW Village Pkwy
Port Saint Lucie, FL 34987-2594
Phone
(772) 879-8700
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 40155 FL Primary

Addresses

Primary practice location

10198 SW Village Pkwy
Port Saint Lucie, FL 34987-2594

Mailing address

1950 SE Dupont St
Port Saint Lucie, FL 34952-6723
Phone (772) 807-2429

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230524002589 FL Practitioner - Physical Therapist in Private Practice 0840656435 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aries PTGroup PAC ID 5395172811, 14 clinicians

Practice addresses (Care Compare)

1115 E Sunrise Blvd
Ft Lauderdale, FL 33304-2809
Phone (954) 247-4929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40155FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Wellness Centers LLC CurrentSince May 15, 2023 Accepting new patients
Aries PT Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Complete Therapy USA Inc. Physical Therapist CurrentSince Jul 26, 2024 Accepting new patients

Locations

1115 E Sunrise Blvd
Ft Lauderdale, FL 33304
Phone (954) 245-0697

2627 NE 203rd St
Ste 110
Miami, FL 33180
Phone (305) 466-1388

10198 SW Village Pkwy
Ste 104
Port St Lucie, FL 34987
Phone (772) 879-8700

Organizations & group practices 3

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1740970532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SE DUPONT ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349526723",
            "telephone_number": "772-807-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10198 SW VILLAGE PKWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872594",
            "telephone_number": "772-879-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "ANDREA",
        "middle_name": "GABRIELA",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "40155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.