Individual provider Active NPI

Larisa Helene Trach, PT, DPT, CSCS

  • Physical Therapist
  • St Petersburg, FL
National Provider Identifier
1801373113
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34060 Issued in FL
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

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PT34060FLMDPhysical Therapist
26999MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.