Individual provider Active NPI

Corey Alexander Gonzalez, PT, DPT, CSCS

  • Orthopedic Physical Therapist
  • Palm Beach Gardens, FL
National Provider Identifier
1760039143
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT34941 Issued in FL
Practice address
11000 Prosperity Farms Rd Ste 203
Palm Beach Gardens, FL 33410-3462
Phone
(561) 432-0111
Fax
(561) 432-1075
NPI assigned
Aug 21, 2019
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT34941 FL Primary

Addresses

Primary practice location

11000 Prosperity Farms Rd Ste 203
Palm Beach Gardens, FL 33410-3462

Mailing address

5840 Corporate Way Ste 100
West Palm Beach, FL 33407-2040
Phone (561) 432-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200127000669 FL Practitioner - Physical Therapist in Private Practice 4880029503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-5255

Merit-based Incentive Payment System (MIPS)

Final score
81.65 of 100Reported as group
Quality
66.27
Promoting interoperability
100
Improvement activities
40
Cost
72.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services II, LLC CurrentSince Dec 28, 2020 Accepting new patients
Tenet Florida Physician Services II, LLC Orthopedic CurrentSince Dec 28, 2020 Accepting new patients

Locations

3000 Bayview Dr
#100
Fort Lauderdale, FL 33306
Phone (954) 567-1332

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

3000 Bayview Dr
Ste 100
Ft Lauderdale, FL 33306
Phone (954) 567-1332

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

Interoperability endpoints

  • Direct secure messaging: corey.gonzalez.1@13023.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1760039143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 CORPORATE WAY STE 100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072040",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 PROSPERITY FARMS RD STE 203",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103462",
            "telephone_number": "561-432-0111",
            "fax_number": "561-432-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "COREY",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT34941",
            "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 Jul 16, 2020; 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.