Individual provider Active NPI

Anne Jekka Castro Garcia, PT

  • Physical Therapist
  • Sunrise, FL
National Provider Identifier
1992078240
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0002813 Issued in DE
Practice address
1580 Sawgrass Corporate Pkwy
Suite 100
Sunrise, FL 33323-2859
Phone
(954) 739-4247
NPI assigned
Feb 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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 J1-0002813 DE Primary

Addresses

Primary practice location

1580 Sawgrass Corporate Pkwy
Suite 100
Sunrise, FL 33323-2859

Mailing address

4021 N Pine Island Rd
Shamrock Apt.404
Sunrise, FL 33351-6520
Phone (954) 315-8053

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190613001423 DE Practitioner - Physical Therapist in Private Practice 2961735519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kent Physical Therapy, LLCGroup PAC ID 8123361169, 4 clinicians

Practice addresses (Care Compare)

1078 S State St
Suite 1
Dover, DE 19901-6925
Phone (302) 401-7778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
J1-0002813DEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kent Physical Therapy, LLC Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Medpro Healthcare Staffing Past Accepting new patients

Locations

1078 S State St
Ste 1
Dover, DE 19901
Phone (302) 401-7778

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": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1992078240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 N PINE ISLAND RD",
            "address_2": "SHAMROCK APT.404",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516520",
            "telephone_number": "954-315-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY",
            "address_2": "SUITE 100",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232859",
            "telephone_number": "954-739-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "ANNE JEKKA",
        "middle_name": "CASTRO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0002813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.