Individual provider Active NPI

Heidy Lopez

  • Physical Therapist
  • Palm Beach Gardens, FL
National Provider Identifier
1750112892
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
41622 Issued in FL
Practice address
3385 Burns Rd Ste 108
Palm Beach Gardens, FL 33410-4328
Phone
(561) 432-0111
Fax
(561) 432-1075
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 41622 FL Primary

Addresses

Primary practice location

3385 Burns Rd Ste 108
Palm Beach Gardens, FL 33410-4328

Mailing address

3 Glamis Way
Boynton Beach, FL 33426-7617
Phone (561) 543-1793

Other practice location 1

8645 N Military Trl Ste 401
West Palm Beach, FL 33410-6295
Phone (561) 662-5863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829003824 FL Practitioner - Physical Therapist in Private Practice 2961941208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Neuro Rehab, LLCGroup PAC ID 8022465350, 7 clinicians

Practice addresses (Care Compare)

166 Seabreeze Cir
Jupiter, FL 33477-6426
Phone (561) 662-5863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41622FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Neuro Rehab, LLC Physical Therapist CurrentSince Aug 25, 2024 Accepting new patients

Locations

8645 N Military Trl
Ste 401
West Palm Beach, FL 33410
Phone (561) 510-7136

Organizations & group practices 1

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1750112892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GLAMIS WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334267617",
            "telephone_number": "561-543-1793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 BURNS RD STE 108",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104328",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8645 N Military Trl Ste 401",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334106295",
            "country_code": "US",
            "telephone_number": "561-662-5863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "HEIDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "41622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.