Heidi S Rosasco, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

528 B Cecil Costin Blvd
Port St Joe, FL 32456

Phone

(850) 252-1414

Fax

(850) 388-4555

NPI assigned

May 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Florida College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excellence Physical Therapy LLCGroup PAC ID 8527484054, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Excellence Physical Therapy LLC

  • Clinic/Center
  • Lynn Haven, FL
  • NPI 1679109953

  FL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1750120432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 S HIGHWAY 77 STE 200",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444641",
            "telephone_number": "850-252-1414",
            "fax_number": "850-388-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 B CECIL COSTIN BLVD",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "32456",
            "telephone_number": "850-252-1414",
            "fax_number": "850-388-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSASCO",
        "first_name": "HEIDI",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Port St Joe Opco LLC
• Premier Rehab Management, LLC
• Shameka Ashawn Raines
• Judith Renfroe Romiti, RN
• Jeffrey Robert Root, M.D.
• Sacred Heart on the Gulf
• Sacred Heart on the Gulf
• Salt and Ivy Gulf LLC
• Braden J Shaffer, APN
• Shivam Shah, MD

• All providers in Port St Joe, FL
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.