Individual provider Active NPI

Sydney Novak, PT, DPT

  • Physical Therapist
  • Palm Bay, FL
National Provider Identifier
1861218380
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42548 Issued in FL
Practice address
470 Malabar Rd SE Unit 102
Palm Bay, FL 32907-3124
Phone
(321) 802-9645
Fax
(321) 802-9647
NPI assigned
Nov 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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 PT42548 FL Primary

Addresses

Primary practice location

470 Malabar Rd SE Unit 102
Palm Bay, FL 32907-3124

Mailing address

470 Malabar Rd SE Unit 102
Palm Bay, FL 32907-3124
Phone (321) 802-9645

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211000007 FL Practitioner - Physical Therapist in Private Practice 1355877580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy Professionals LLCGroup PAC ID 2567461825, 14 clinicians

Practice addresses (Care Compare)

470 Malabar Rd SE
Suite 102
Palm Bay, FL 32907-3103
Phone (321) 802-9645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Professionals, LLC Physical Therapist CurrentSince Dec 4, 2024 Accepting new patients

Locations

8045 Spyglass Hill Rd
Ste 103
Melbourne, FL 32940
Phone (321) 757-5515

470 Malabar Rd SE
Unit 102
Palm Bay, FL 32907
Phone (321) 591-4369

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": "1732924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1861218380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 MALABAR RD SE UNIT 102",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329073124",
            "telephone_number": "321-802-9645",
            "fax_number": "321-802-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 MALABAR RD SE UNIT 102",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329073124",
            "telephone_number": "321-802-9645",
            "fax_number": "321-802-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAK",
        "first_name": "SYDNEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-30",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; 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.