Individual provider Active NPI

Lori Michelle Gendreau, PT

  • Physical Therapist
  • Lake Mary, FL
National Provider Identifier
1871779108
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16018 Issued in MA
Practice address
250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030
Phone
(800) 954-9645
NPI assigned
Jan 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32915 CA
Physical Therapist 225100000X 1178760 TX
Physical Therapist 225100000X 16018 MA Primary

Addresses

Primary practice location

250 International Pkwy
Suite 260
Lake Mary, FL 32746-5030

Mailing address

23 Lovett Ave
Brockton, MA 02301-1750
Phone (617) 480-6170

Other names 1

  • Lori Trapp Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302002605 MA Practitioner - Physical Therapist in Private Practice 4587037049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

86 Saunders Rd
Norwood, MA 02062-3242
Phone (781) 285-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16018MAMDPharmacist
32915CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jan 24, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jan 24, 2023 Accepting new patients

Locations

86 Saunders Rd
Norwood, MA 02062
Phone (781) 285-7950

Organizations & group practices 2

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": "1200441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1871779108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LOVETT AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011750",
            "telephone_number": "617-480-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 INTERNATIONAL PKWY",
            "address_2": "SUITE 260",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465030",
            "telephone_number": "800-954-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDREAU",
        "first_name": "LORI",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-16",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "32915",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1178760",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "16018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "TRAPP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.