Active NPI
Larisa Helene Trach, PT, DPT, CSCS
- Physical Therapist
- St Petersburg, FL
National Provider Identifier
1801373113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34060
- Practice address
- 880 6TH St S
St Petersburg, FL 33701-4827 - Phone
- (727) 767-3253
- NPI assigned
- Jul 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 26999 | MD | |
| Physical Therapist | 225100000X | PT34060 | FL | Primary |
Addresses
Primary practice location
880 6TH St S
St Petersburg, FL 33701-4827
Mailing address
880 6TH St S
St Petersburg, FL 33701-4827
Phone (727) 767-3253
Other practice location 1
3850 Tampa Rd
Palm Harbor, FL 34684-3670
Phone (727) 767-3253
Other practice location 2
4924 Campbell Blvd Ste 130A
Nottingham, MD 21236-5909
Phone (443) 997-5476
Other practice location 3
5690 Bollettieri Blvd
Bradenton, FL 34210
Phone (941) 749-8780
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT34060 | FL | MD | Physical Therapist |
| 26999 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Physician Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- St Petersburg, FL
- NPI 1770532798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570060800000",
"number": "1801373113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "880 6TH ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014827",
"telephone_number": "727-767-3253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "880 6TH ST S",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014827",
"telephone_number": "727-767-3253"
}
],
"practiceLocations": [
{
"address_1": "3850 Tampa Rd",
"address_purpose": "LOCATION",
"city": "Palm Harbor",
"state": "FL",
"postal_code": "346843670",
"country_code": "US",
"telephone_number": "727-767-3253",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4924 Campbell Blvd Ste 130A",
"address_purpose": "LOCATION",
"city": "Nottingham",
"state": "MD",
"postal_code": "212365909",
"country_code": "US",
"telephone_number": "443-997-5476",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5690 Bollettieri Blvd",
"address_purpose": "LOCATION",
"city": "Bradenton",
"state": "FL",
"postal_code": "34210",
"country_code": "US",
"telephone_number": "941-749-8780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRACH",
"first_name": "LARISA",
"middle_name": "HELENE",
"credential": "PT, DPT, CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-19",
"last_updated": "2019-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26999",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT34060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.