Individual provider Active NPI

Mark Francis Pangilinan, DPT

  • Physical Therapist
  • Lake Wales, FL
National Provider Identifier
1962199059
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39932 Issued in FL
Practice address
425 S 11TH St Ste 3
Lake Wales, FL 33853-4239
Phone
(863) 676-0174
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 055558 NY
Physical Therapist 225100000X 39932 FL Primary

Addresses

Primary practice location

425 S 11TH St Ste 3
Lake Wales, FL 33853-4239

Mailing address

882 Reflections Loop E
Winter Haven, FL 33884-3567
Phone (863) 969-8266

Other practice location 1

4701 Queens Blvd
Sunnyside, NY 11104-1660
Phone (191) 731-0277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260603003822 NY Practitioner - Physical Therapist in Private Practice 0446721161

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

4701 Queens Blvd
Sunnyside, NY 11104-1660
Phone (917) 310-2772

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39932FLMDPhysical Therapist
055558NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Polk South Inc PastSince Apr 23, 2023 Accepting new patients

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1962199059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 REFLECTIONS LOOP E",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843567",
            "telephone_number": "863-969-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S 11TH ST STE 3",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534239",
            "telephone_number": "863-676-0174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Queens Blvd",
            "address_purpose": "LOCATION",
            "city": "Sunnyside",
            "state": "NY",
            "postal_code": "111041660",
            "country_code": "US",
            "telephone_number": "191-731-0277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGILINAN",
        "first_name": "MARK FRANCIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "055558",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "39932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.