Individual provider Active NPI

Madeline Elena Fezzie, OTR/L

  • Occupational Therapist
  • Sun City Center, FL
National Provider Identifier
1972213510
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT23678 Issued in FL
Practice address
1513 Sun City Center PLZ
Sun City Center, FL 33573-5390
Phone
(813) 634-6022
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT23678 FL Primary

Addresses

Primary practice location

1513 Sun City Center PLZ
Sun City Center, FL 33573-5390

Mailing address

11528 Wellman Dr
Riverview, FL 33578-3765
Phone (863) 660-3801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913002520 FL Practitioner - Occupational Therapist in Private Practice 8628518867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

430 Morton Plant St
Suite 206
Clearwater, FL 33756-3396
Phone (813) 978-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Sep 18, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Aug 12, 2024 Accepting new patients
Musculoskeletal Institute Chartered Occupational Therapist Current Accepting new patients
Tallahassee Orthopedic Clinic III PL CurrentSince Sep 18, 2024 Accepting new patients
Musculoskeletal Institute Chartered CurrentSince Aug 12, 2024 Accepting new patients

Locations

430 Morton Plant St
Clearwater, FL 33756
Phone (727) 461-8360

430 Morton Plant St
Ste 206
Clearwater, FL 33756
Phone (727) 298-5230

430 Morton Plant St
Ste 301
Clearwater, FL 33756

8839 Bryan Dairy Rd
Ste 240
Largo, FL 33777
Phone 81397897007646

8839 Bryan Dairy Rd
Ste 240A
Largo, FL 33777

2011 Harrison Ave
Panama City, FL 32405
Phone (850) 691-4188

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

8839 Bryan Dairy Rd
Ste 240B
Seminole, FL 33777
Phone (727) 591-3080

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

13020 N Telecom Pkwy
Temple Terrace, FL 33637

5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700

13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637

2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000

Organizations & group practices 5

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1972213510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11528 WELLMAN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783765",
            "telephone_number": "863-660-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 SUN CITY CENTER PLZ",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735390",
            "telephone_number": "813-634-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEZZIE",
        "first_name": "MADELINE",
        "middle_name": "ELENA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT23678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.