Individual provider Active NPI

Gina Marrama Komar, DPT

  • Physical Therapist
  • Valrico, FL
National Provider Identifier
1790798122
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34508 Issued in FL
Practice address
1586 Bloomingdale Ave
Valrico, FL 33596-6101
Phone
(813) 978-9700
Fax
(813) 558-6186
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015301 PA
Physical Therapist 225100000X PT49QA01134800 NJ
Physical Therapist 225100000X PT34508 FL Primary

Addresses

Primary practice location

1586 Bloomingdale Ave
Valrico, FL 33596-6101

Mailing address

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Other practice location 1

7 Carnegie Plaza
Cherry Hill, NJ 08003-1020
Phone (877) 407-3422

Other names 1

  • Gina Ann Marrama Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200408002855 FL Practitioner - Physical Therapist in Private Practice 3072792654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahassee Orthopedic Clinic III PLGroup PAC ID 4284532755, 538 clinicians

Practice addresses (Care Compare)

1586 Bloomingdale Ave
Valrico, FL 33596-6101
Phone (813) 978-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT49QA01134800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 16, 2024 Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Sep 16, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Mar 9, 2021 Accepting new patients

Locations

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

1586 Bloomingdale Ave
Valrico, FL 33596
Phone (813) 558-6850

1586 Bloomingdale Ave
Ste 101
Valrico, FL 33596

1586 Bloomingdale Ave
Fl Orthopaedic
Valrico, FL 33596

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: gina.komar.1@18802.direct.athenahealth.com

Organizations & group practices 4

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1790798122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370925",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1586 BLOOMINGDALE AVE",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966101",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Carnegie Plaza",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080031020",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMAR",
        "first_name": "GINA",
        "middle_name": "MARRAMA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT015301",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "PT49QA01134800",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "MARRAMA",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Valrico, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.