Individual provider Active NPI

Ameliah E Martinez-Tiberi, PT, DPT

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1790239812
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32522 Issued in FL
Practice address
1650 Medical LN Ste 4
Fort Myers, FL 33907-1116
Phone
(239) 334-6160
Fax
(239) 334-1339
NPI assigned
Aug 5, 2016
Last updated
May 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60668046 WA
Physical Therapist 225100000X PT32522 FL Primary

Addresses

Primary practice location

1650 Medical LN Ste 4
Fort Myers, FL 33907-1116

Mailing address

P.O. Box 51319
Fort Myers, FL 33994-1119
Phone (239) 334-6160

Other identifiers 1

IdentifierTypeStateIssuer
023295800MedicaidFL

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
PT32522FLMDPhysical Therapist
PT60668046WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1790239812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 51319",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339941119",
            "telephone_number": "239-334-6160",
            "fax_number": "239-334-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MEDICAL LN STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071116",
            "telephone_number": "239-334-6160",
            "fax_number": "239-334-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-TIBERI",
        "first_name": "AMELIAH",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60668046",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023295800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.