Active NPI
Gina Nguyen
- Physical Therapist
- St Petersburg, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT36790
- Practice address
- 4020 Park St N Ste 101
St Petersburg, FL 33709-4030 - Phone
- (727) 388-4688
- Fax
- (727) 388-6887
- NPI assigned
- Aug 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT36790 | FL | Primary |
Addresses
Primary practice location
4020 Park St N Ste 101
St Petersburg, FL 33709-4030
Mailing address
1412 S Madison Ave
Clearwater, FL 33756-2246
Phone (850) 341-0779
Other practice location 1
25241 Elementary Way Ste 200
Bonita Springs, FL 34135-7883
Phone (239) 947-4184
Other practice location 2
10676 Colonial Blvd Ste 50
Fort Myers, FL 33913-8715
Phone (239) 465-4880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.26 of 100
- Quality
- 86.58
- Improvement activities
- 40
- Cost
- 68.79
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT36790 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sobe Innovative Rehabilitation PLLC | Physical Therapist | Current | Accepting new patients |
| Hays S Estes DPT PLLC | Physical Therapist | Current | Accepting new patients |
| Fyzbiz, LLC | Physical Therapist | Past | Accepting new patients |
| Douglass Orthopedic & Spine Rehabilitation, Inc. | Physical Therapist | Past | Accepting new patients |
Locations
2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014
1661 Rainbow Dr
Clearwater, FL 33755
Phone (727) 442-7500
Networks
- 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.
-
- Physical Therapy Clinic/Center
- Clearwater, FL
- NPI 1922013408
Physical Therapist
-
- Physical Therapist
- Miami, FL
- NPI 1164800595
-
- Physical Therapist
- Bonita Springs, FL
- NPI 1992762298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1962013276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 S MADISON AVE",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337562246",
"telephone_number": "850-341-0779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 PARK ST N STE 101",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337094030",
"telephone_number": "727-388-4688",
"fax_number": "727-388-6887"
}
],
"practiceLocations": [
{
"address_1": "25241 Elementary Way Ste 200",
"address_purpose": "LOCATION",
"city": "Bonita Springs",
"state": "FL",
"postal_code": "341357883",
"country_code": "US",
"telephone_number": "239-947-4184",
"fax_number": "239-947-4171",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "10676 Colonial Blvd Ste 50",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339138715",
"country_code": "US",
"telephone_number": "239-465-4880",
"fax_number": "239-465-4604",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NGUYEN",
"first_name": "GINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-11",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT36790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.