Individual provider Active NPI

Jose Joaquin Stable, PT,PTA.,LMT

  • Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1770683583
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32333 Issued in FL
Practice address
2602 N Federal Hwy
Boynton Beach, FL 33435-2413
Phone
(561) 738-6691
Fax
(561) 777-7878
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 18956 FL
Massage Therapist 225700000X MA35991 FL
Physical Therapist 225100000X PT32333 FL Primary

Addresses

Primary practice location

2602 N Federal Hwy
Boynton Beach, FL 33435-2413

Mailing address

2602 N Federal Hwy
Boynton Beach, FL 33435-2413
Phone (561) 738-6691

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113001154 FL Practitioner - Physical Therapist in Private Practice 5890120281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2602 N Federal Hwy
Boynton Beach, FL 33435-2413
Phone (561) 738-6691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTA 18956FLMDPhysical Therapy Assistant
MA35991FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jose Stable Physiotherapy LLC Physical Therapist CurrentSince Nov 2, 2019 Accepting new patients

Locations

2602 N Federal Hwy
Boynton Beach, FL 33435
Phone (561) 738-6691

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1770683583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 N FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334352413",
            "telephone_number": "561-738-6691",
            "fax_number": "561-777-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 N FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334352413",
            "telephone_number": "561-738-6691",
            "fax_number": "561-777-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABLE",
        "first_name": "JOSE",
        "middle_name": "JOAQUIN",
        "credential": "PT,PTA.,LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 18956",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA35991",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.