Jason Robert Bach-Randolph

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT34952 Issued in FL

Practice address

530 E Olympia Ave Ste 112
Punta Gorda, FL 33950-3838

Phone

(941) 575-7300

Fax

(941) 505-7301

NPI assigned

Aug 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jason Robert Randolph Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fitness Quest - Venice LLCGroup PAC ID 9739125964, 44 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Fitness Quest - Venice LLC

  • Physical Therapy Clinic/Center
  • Lakewood Ranch, FL
  • NPI 1033129895

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Fitness Quest - Bradenton LLC

  • Physical Therapy Clinic/Center
  • Englewood, FL
  • NPI 1528219631
  Medicare reassignment NPD
• Fitness Quest - North Port LLC

  • Physical Therapy Clinic/Center
  • North Port, FL
  • NPI 1639257405

  Physical Therapist

  Medicare reassignment NPD
• Fitness Quest - Punta Gorda LLC

  • Physical Therapy Clinic/Center
  • Punta Gorda, FL
  • NPI 1043220817

  Physical Therapist

  Medicare reassignment NPD
• Fitness Quest-Port Charlotte LLC

  • Physical Therapy Clinic/Center
  • Port Charlotte, FL
  • NPI 1679761696

  Physical Therapist

  Medicare reassignment NPD
• Fq0014

  • Physical Therapy Clinic/Center
  • Fort Myers, FL
  • NPI 1467079368

  Physical Therapist

  Medicare reassignment NPD
• Fq0016, LLC

  • Physical Therapy Clinic/Center
  • North Fort Myers, FL
  • NPI 1134885148

  Physical Therapist

  Medicare reassignment NPD
• Fitness Quest - Venice LLC

  • Durable Medical Equipment & Medical Supplies
  • Longboat Key, FL
  • NPI 1427936889
  NPD

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1780239392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E OLYMPIA AVE STE 112",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503838",
            "telephone_number": "941-575-7300",
            "fax_number": "941-505-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E OLYMPIA AVE STE 112",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503838",
            "telephone_number": "941-575-7300",
            "fax_number": "941-505-7301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4161 Tamiami Trl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339529204",
            "country_code": "US",
            "telephone_number": "941-743-6700",
            "fax_number": "941-743-6707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2530 Bobcat Village Center Rd Unit C",
            "address_purpose": "LOCATION",
            "city": "North Port",
            "state": "FL",
            "postal_code": "342888475",
            "country_code": "US",
            "telephone_number": "941-426-7400",
            "fax_number": "941-426-7044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2828 S McCall Rd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "FL",
            "postal_code": "342249517",
            "country_code": "US",
            "telephone_number": "941-474-2700",
            "fax_number": "941-474-8081",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Boca Grande",
            "state": "FL",
            "postal_code": "33921",
            "country_code": "US",
            "telephone_number": "941-964-2300",
            "fax_number": "941-964-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH-RANDOLPH",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT34952",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlopez@fitnessquestpt.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "530 E Olympia Ave Ste 112",
            "city": "Punta Gorda",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339503838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "RANDOLPH",
            "middle_name": "ROBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Athletic Solutions, PLLC
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• Autumn Home Care of South Western Florida, LLC
• Lawrence R Bachle, DO
• Back2Nature Inc
• Eulalee Bailey
• Steven Sidney Baker, MD
• Niraj D Banjara, PHARMACIST

• Physical Therapist in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.