Individual provider Active NPI

Bradley Nolin, MPT

  • Physical Therapist
  • Palm Beach Gardens, FL
National Provider Identifier
1821044249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 20257 Issued in FL
Practice address
11550 Mirasol Way
Palm Beach Gardens, FL 33418-6208
Phone
(561) 632-2160
Fax
(561) 842-6458
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 20257 FL Primary

Addresses

Primary practice location

11550 Mirasol Way
Palm Beach Gardens, FL 33418-6208

Mailing address

513 Driftwood Rd
North Palm Beach, FL 33408-4813
Phone (561) 632-2160

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000730 FL Practitioner - Physical Therapist in Private Practice 5890725832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Site Physical Therapy LLCGroup PAC ID 7810916897, 21 clinicians

Practice addresses (Care Compare)

11261 US Hwy 1
North Palm Beach, FL 33408-3216
Phone (561) 632-2160

11550 Mirasol Way
Palm Beach Gardens, FL 33418-6208
Phone (561) 632-2160

200 Admirals Cove Blvd
Jupiter, FL 33477-4046
Phone (561) 632-2160

2401 Willow Springs Dr
Boca Raton, FL 33496-2812
Phone (561) 632-2160

3500 Clubhouse LN
Boynton Beach, FL 33436-6002
Phone (561) 735-8559

7667 Victory LN
Delray Beach, FL 33446-3155
Phone (561) 632-2160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 20257FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Rehabilitation, Inc Physical Therapist CurrentSince Sep 12, 2005 Accepting new patients
On Site Physical Therapy LLC Physical Therapist CurrentSince Nov 1, 2005 Accepting new patients
On Site Physical Therapy LLC Past Accepting new patients
On Site Physical Therapy LLC Past Accepting new patients

Locations

13205 US Highway 1
Ste 109
Juno Beach, FL 33408
Phone (561) 627-2525

790 Juno Ocean Walk
Ste 504C
Juno Beach, FL 33408
Phone (561) 627-2525

200 Admirals Cove Blvd
Jupiter, FL 33477
Phone (561) 745-5920

521 Lake Ave
Ste 8
Lake Worth, FL 33460
Phone (305) 484-0832

8100 Ibis Blvd
West Palm Beach, FL 33412
Phone (561) 625-8500

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821044249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 DRIFTWOOD RD",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334084813",
            "telephone_number": "561-632-2160",
            "fax_number": "561-842-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 MIRASOL WAY",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334186208",
            "telephone_number": "561-632-2160",
            "fax_number": "561-842-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLIN",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 20257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.