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

Last updated

May 22, 2024By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Excellence Physical Therapy LLC

  • Clinic/Center
  • Lynn Haven, FL
  • NPI 1679109953
  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 (Salt and Ivy Health and Wellness)
• Braden J Shaffer, APN
• Shivam Shah, MD

• Physical Therapist in Port St Joe, FL
• Providers in Port St Joe, 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 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.