Individual provider Active NPI

Regina Samaan

  • Physical Therapist
  • Lake Mary, FL
National Provider Identifier
1790595932
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42666 Issued in FL
Practice address
875 Wallace CT
Lake Mary, FL 32746-2161
Phone
(407) 710-8956
NPI assigned
Jan 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 PT42666 FL Primary

Addresses

Primary practice location

875 Wallace CT
Lake Mary, FL 32746-2161

Mailing address

875 Wallace CT
Lake Mary, FL 32746-2161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250116002687 FL Practitioner - Physical Therapist in Private Practice 5890223937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

875 Wallace CT
Suit C Unit 1013
Lake Mary, FL 32746-2161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42666FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regent Therapy Services LLC. Physical Therapist CurrentSince Feb 3, 2025 Accepting new patients

Locations

875 Wallace Ct
Unit 1013
Lake Mary, FL 32746
Phone (734) 578-5171

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1790595932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 WALLACE CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 WALLACE CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462161",
            "telephone_number": "407-710-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAAN",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.