Individual provider Active NPI

Bernadette Mallari

  • Physical Therapist
  • Altamonte Springs, FL
National Provider Identifier
1760854913
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 7182 Issued in FL
Practice address
1099 West Town Parkway
Consulate Health Care at West Altamonte
Altamonte Springs, FL 32714
Phone
(407) 865-8000
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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 PT 7182 FL Primary

Addresses

Primary practice location

1099 West Town Parkway
Consulate Health Care at West Altamonte
Altamonte Springs, FL 32714

Mailing address

1099 West Town Parkway
Consulate Health Care at West Altamonte
Altamonte Springs, FL 32714
Phone (407) 865-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220616000765 FL Practitioner - Physical Therapist in Private Practice 4789063074 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 7182FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Patient Care Specialty Group Florida LLC Physical Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

3800 W Town Center Blvd
Orlando, FL 32837
Phone (407) 251-8088

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1760854913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 WEST TOWN PARKWAY",
            "address_2": "CONSULATE HEALTH CARE AT WEST ALTAMONTE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "32714",
            "telephone_number": "407-865-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 WEST TOWN PARKWAY",
            "address_2": "CONSULATE HEALTH CARE AT WEST ALTAMONTE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "32714",
            "telephone_number": "407-865-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARI",
        "first_name": "BERNADETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 7182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.