NPIMap

Organization Active NPI

Axispro Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Melbourne, FL
National Provider Identifier
1821443474
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT 27353 Issued in FL
Legal business name
AXISPRO PHYSICAL THERAPY LLC
Practice address
405 N Wickham Rd Ste 103
Melbourne, FL 32935-8628
Phone
(321) 327-8509
NPI assigned
May 2, 2016
Last updated
Jul 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Authorized official

Name
Maciej Molik, P.TNPI 1891926176
Title
Owner/Manager
Phone
(321) 514-2844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT 27353 FL Primary

Addresses

Primary practice location

405 N Wickham Rd Ste 103
Melbourne, FL 32935-8628

Mailing address

645 Newport Dr
Indialantic, FL 32903-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20161202001920 FL Part B Supplier - Clinic/Group Practice 5395035158 Receives reassigned benefits from 17 practitioners
Practice locations: Palm Bay, FL; Rockledge, FL; Melbourne, FL
O20200731000524 FL DME Supplier - Independently-Practicing Occupational Therapist 5395035158 Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

405 N Wickham Rd
Ste 103
Melbourne, FL 32935
Phone (321) 327-8509

5240 Babcock St NE
Ste 102
Palm Bay, FL 32905
Phone (321) 327-8509

760 Barnes Blvd
Ste 103
Rockledge, FL 32955
Phone (321) 327-8509

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785110400000",
    "number": "1821443474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 NEWPORT DR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WICKHAM RD STE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358628",
            "telephone_number": "321-327-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXISPRO PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A",
        "authorized_official_last_name": "MOLIK",
        "authorized_official_first_name": "MACIEJ",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "321-514-2844",
        "authorized_official_credential": "P.T"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT 27353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.