Individual provider Active NPI

John Allen Hisamoto, P.T.

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1962490938
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5271 Issued in FL
Practice address
13801 Bruce B Downs Blvd
Suite 303
Tampa, FL 33613-3946
Phone
(813) 979-4819
Fax
(813) 975-8708
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PT5271 FL Primary

Addresses

Primary practice location

13801 Bruce B Downs Blvd
Suite 303
Tampa, FL 33613-3946

Mailing address

22819 Southshore Dr
Land O Lakes, FL 34639-4755
Phone (813) 979-4819

Other identifiers 2

IdentifierTypeStateIssuer
K2780OtherMEDICARE GROUP NUMBER
Y4306OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5271FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation, Inc. CurrentSince May 30, 2025 Accepting new patients
Proactive Physical Therapy of Wesley Chapel Inc Physical Therapist PastSince Dec 1, 2007 Accepting new patients

Locations

13801 Bruce B Downs Blvd
Ste 303
Tampa, FL 33613
Phone (813) 979-4819

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962490938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22819 SOUTHSHORE DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346394755",
            "telephone_number": "813-979-4819",
            "fax_number": "813-975-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD",
            "address_2": "SUITE 303",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133946",
            "telephone_number": "813-979-4819",
            "fax_number": "813-975-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISAMOTO",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT5271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "K2780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y4306",
            "state": null
        }
    ],
    "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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.