Individual provider Active NPI

Rosalie Dominguez, PT

  • Physical Therapist
  • Palm Beach, FL
National Provider Identifier
1801080767
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6974 Issued in FL
Practice address
300 Royal Palm Way
Palm Beach, FL 33480-4305
Phone
(561) 655-7266
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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 PT6974 FL Primary

Addresses

Primary practice location

300 Royal Palm Way
Palm Beach, FL 33480-4305

Mailing address

7200 W Camino Real
#101
Boca Raton, FL 33433-5511
Phone (561) 417-9563

Other practice location 1

7200 W Camino Real
#101
Boca Raton, FL 33433-5511
Phone (561) 417-9563

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
PT6974FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Center for Children and Adults Past Accepting new patients
Rehabilitation Physicians PA PastSince Jan 27, 1997 Accepting new patients

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1801080767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W CAMINO REAL",
            "address_2": "#101",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335511",
            "telephone_number": "561-417-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ROYAL PALM WAY",
            "city": "PALM BEACH",
            "state": "FL",
            "postal_code": "334804305",
            "telephone_number": "561-655-7266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 W Camino Real",
            "address_2": "#101",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334335511",
            "country_code": "US",
            "telephone_number": "561-417-9563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "ROSALIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT6974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.