Individual provider Active NPI

Temistocles Ruben Pozo, PT

  • Physical Therapist
  • Lake Worth, FL
National Provider Identifier
1790764140
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8467 Issued in FL
Practice address
6508 Blue Bay Cir
Lake Worth, FL 33467-7219
Phone
(561) 236-4523
Fax
(561) 478-9349
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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 PT8467 FL Primary

Addresses

Primary practice location

6508 Blue Bay Cir
Lake Worth, FL 33467-7219

Mailing address

6508 Blue Bay Cir
Lake Worth, FL 33467-7219
Phone (561) 236-4523

Other identifiers 2

IdentifierTypeStateIssuer
Y8774XOtherFLMEDICARE PTAN SENIOR FIRST
Y8774YOtherFLMEDICARE PTAN CENTER FOR BALANCE, DIZZINESS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823000362 FL Practitioner - Physical Therapist in Private Practice 7214830587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Physical Therapy Group, LLC Physical Therapist CurrentSince Jun 15, 2021 Accepting new patients
Vestbular Rehabilitation and Dizziness Center Inc Past Accepting new patients
Center for Balance, Dizziness and Physical Therapy LLC Past Accepting new patients
Physical Therapy in Your Home Inc Past Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients

Organizations & group practices 5

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304640000000",
    "number": "1790764140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 BLUE BAY CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677219",
            "telephone_number": "561-236-4523",
            "fax_number": "561-478-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 BLUE BAY CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677219",
            "telephone_number": "561-236-4523",
            "fax_number": "561-478-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POZO",
        "first_name": "TEMISTOCLES",
        "middle_name": "RUBEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2011-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT8467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN SENIOR FIRST",
            "identifier": "Y8774X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN CENTER FOR BALANCE, DIZZINESS",
            "identifier": "Y8774Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.