Individual provider Active NPI

Elias Henriquez, DPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1881204345
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36043 Issued in FL
Practice address
9415 Sunset Dr Ste 111
Miami, FL 33173-5492
Phone
(786) 507-8278
Fax
(844) 214-1486
NPI assigned
Aug 8, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 PT36043 FL Primary

Addresses

Primary practice location

9415 Sunset Dr Ste 111
Miami, FL 33173-5492

Mailing address

21756 State Road 54
Ste 102
Lutz, FL 33549-2905
Phone (727) 475-5540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200826002563 FL Practitioner - Physical Therapist in Private Practice 0749607463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Performance and Physical Therapies Kendall LLCGroup PAC ID 4981842192, 7 clinicians

Practice addresses (Care Compare)

9415 Sunset Dr
Suite 111
Miami, FL 33173-5492
Phone (786) 507-8278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT36043FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies Kendall LLC Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients

Locations

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

9415 Sunset Dr
Ste 111
Miami, FL 33173
Phone (786) 507-8278

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1881204345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54",
            "address_2": "STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905",
            "telephone_number": "727-475-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 SUNSET DR STE 111",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735492",
            "telephone_number": "786-507-8278",
            "fax_number": "844-214-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "ELIAS",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-08",
        "last_updated": "2023-03-28",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.