Individual provider Active NPI

Adam M Schoenberg, MPT ATC

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1982631461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21432 Issued in FL
Practice address
12421 San Jose Blvd
Suite 100
Jacksonville, FL 32223-2680
Phone
(904) 292-0195
Fax
(904) 292-0566
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT21432 FL Primary

Addresses

Primary practice location

12421 San Jose Blvd
Suite 100
Jacksonville, FL 32223-2680

Mailing address

12421 San Jose Blvd
Suite 100
Jacksonville, FL 32223-2680
Phone (904) 292-0195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013001119 FL Practitioner - Physical Therapist in Private Practice 7810957958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlas Physical Therapy and Sports Medicine IncGroup PAC ID 8426017807, 11 clinicians

Practice addresses (Care Compare)

12421 San Jose Blvd
Suite 100
Jacksonville, FL 32223-8662
Phone (904) 292-0195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlas Physical Therapy & Sports Medicine Inc Physical Therapist CurrentSince Jan 24, 2021 Accepting new patients
Atlas Physical Therapy & Sports Medicine Inc Physical Therapist CurrentSince Jan 14, 2013 Accepting new patients

Locations

12421 San Jose Blvd
Ste 100
Jacksonville, FL 32223
Phone (904) 292-0195

165 Hampton Point Dr
Ste 3
Saint Augustine, FL 32092
Phone (904) 429-0290

425 W Town Pl
Ste 102
St Augustine, FL 32092
Phone (904) 292-0195

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982631461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 SAN JOSE BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232680",
            "telephone_number": "904-292-0195",
            "fax_number": "904-292-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12421 SAN JOSE BLVD",
            "address_2": "SUITE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322232680",
            "telephone_number": "904-292-0195",
            "fax_number": "904-292-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBERG",
        "first_name": "ADAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MPT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.