Individual provider Active NPI

Paulette Rysanek, LPTA

  • Physical Therapy Assistant
  • Land O' Lakes, FL
National Provider Identifier
1780862656
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
20276 Issued in FL
Practice address
7227 Land O Lakes Blvd
Land O Lakes, FL 34638-2826
Phone
(813) 794-2000
NPI assigned
Feb 4, 2008
Last updated
Aug 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X QB01075 NJ
Physical Therapy Assistant 225200000X 20276 FL Primary
Physical Therapy Assistant 225200000X 000616-1 NY
Massage Therapist 225700000X 004316-1 NY

Addresses

Primary practice location

7227 Land O Lakes Blvd
Land O Lakes, FL 34638-2826

Mailing address

7227 Land O Lakes Blvd
Land O Lakes, FL 34638-2826
Phone (813) 794-2000

Other names 1

  • Paulette Bolster Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20276FLMDPhysical Therapy Assistant
QB01075NJMDPhysical Therapy Assistant
000616-1NYMDPhysical Therapy Assistant
004316-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1780862656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LAND O LAKES BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346382826",
            "telephone_number": "813-794-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7227 LAND O LAKES BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346382826",
            "telephone_number": "813-794-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYSANEK",
        "first_name": "PAULETTE",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "QB01075",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "20276",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "000616-1",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "004316-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULETTE",
            "last_name": "BOLSTER",
            "credential": "LPTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Land O' Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.