Individual provider Active NPI

Breck Marie Pribyl, MSPT

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1912002643
Registry record updated Oct 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22332 Issued in FL
Practice address
508 S Habana Ave Ste 140
Tampa, FL 33609-4190
Phone
(813) 877-7200
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2008

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 22332 FL Primary

Addresses

Primary practice location

508 S Habana Ave Ste 140
Tampa, FL 33609-4190

Mailing address

500 Trinity LN N Apt 7310
St Petersburg, FL 33716-1249
Phone (727) 599-6930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000282 FL Practitioner - Physical Therapist in Private Practice 9537298468 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22332FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brad Young Inc CurrentSince Feb 24, 2014 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Optimal Performance and Physical Therapies Hyde Park LLC Physical Therapist PastSince Aug 23, 2010 Accepting new patients

Locations

6231 66th St N
Pinellas Park, FL 33781
Phone (727) 526-2771

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1912002643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TRINITY LN N APT 7310",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161249",
            "telephone_number": "727-599-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE STE 140",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094190",
            "telephone_number": "813-877-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBYL",
        "first_name": "BRECK",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.