Organization Active NPI

Skilled Rehab, Inc.

  • Physical Therapist
  • Lutz, FL
National Provider Identifier
1982612503
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7685 Issued in FL
Legal business name
SKILLED REHAB, INC.
Practice address
1900 Highland Oaks Blvd
Lutz, FL 33559-7323
Phone
(813) 949-0003
Fax
(813) 994-0302
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Maria L Lontoc
Title
Office Manager
Phone
(813) 949-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT7685 FL Primary

Addresses

Primary practice location

1900 Highland Oaks Blvd
Lutz, FL 33559-7323

Mailing address

1900 Highland Oaks Blvd
Lutz, FL 33559-7323
Phone (813) 949-0003

Other identifiers 3

IdentifierTypeStateIssuer
06654OtherFLUNIVERSAL PROVIDER#
6482491OtherFLUHC PROVIDER #
Y921ROtherFLBCBS PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120117000838 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7719154616 Receives reassigned benefits from 1 practitioner
Practice locations: Zephyrhills, FL

National Provider Directory

National Provider Directory

Locations

1900 Highland Oaks Blvd
Lutz, FL 33559
Phone (813) 291-3536

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982612503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HIGHLAND OAKS BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597323",
            "telephone_number": "813-949-0003",
            "fax_number": "813-994-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HIGHLAND OAKS BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597323",
            "telephone_number": "813-949-0003",
            "fax_number": "813-994-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILLED REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONTOC",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "813-949-0003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT7685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL PROVIDER#",
            "identifier": "06654",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER #",
            "identifier": "6482491",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "Y921R",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.