Individual provider Active NPI

Gloria Patricia Choperena, DPT

  • Physical Therapist
  • Miami Lakes, FL
National Provider Identifier
1992044010
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27754 Issued in FL
Practice address
15485 Eagle Nest LN Ste 120
Miami Lakes, FL 33014-2221
Phone
(305) 417-0158
Fax
(305) 602-8929
NPI assigned
Feb 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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 PT27754 FL Primary

Addresses

Primary practice location

15485 Eagle Nest LN Ste 120
Miami Lakes, FL 33014-2221

Mailing address

15485 Eagle Nest LN Ste 120
Miami Lakes, FL 33014-2221
Phone (305) 417-0158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180320002949 FL Practitioner - Physical Therapist in Private Practice 6305077405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15485 Eagle Nest LN
Suite 120
Miami Lakes, FL 33014-2221
Phone (305) 417-0158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT27552FLMDPhysical Therapist
PT27754FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pelvic Care Specialists Corp Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Oasis Specialized Therapy Care PastSince Sep 1, 2017 Accepting new patients

Locations

15485 Eagle Nest Ln
Ste 120
Miami Lakes, FL 33014
Phone (305) 417-0158

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": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1992044010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN STE 120",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142221",
            "telephone_number": "305-417-0158",
            "fax_number": "305-602-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15485 EAGLE NEST LN STE 120",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142221",
            "telephone_number": "305-417-0158",
            "fax_number": "305-602-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOPERENA",
        "first_name": "GLORIA",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.