Individual provider Active NPI

John Fernandez, PT

  • Physical Therapist
  • Arcadia, FL
National Provider Identifier
1992198709
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22418 Issued in FL
Practice address
425 Nursing Home Dr
Arcadia, FL 34266-3839
Phone
(863) 993-2966
Fax
(863) 494-5491
NPI assigned
Mar 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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 22418 FL Primary

Addresses

Primary practice location

425 Nursing Home Dr
Arcadia, FL 34266-3839

Mailing address

425 Nursing Home Dr
Arcadia, FL 34266-3839
Phone (863) 993-2966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506000016 FL Practitioner - Physical Therapist in Private Practice 0941529473 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22418FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Mar 7, 2022 Accepting new patients
Arcadia Medical Associates PA CurrentSince Apr 20, 2015 Accepting new patients
Arcadia Medical Associates PA CurrentSince Apr 20, 2015 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 7, 2022 Accepting new patients

Locations

425 Nursing Home Dr
Arcadia, FL 34266
Phone (863) 494-9991

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Organizations & group practices 4

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": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1992198709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NURSING HOME DR",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663839",
            "telephone_number": "863-993-2966",
            "fax_number": "863-494-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NURSING HOME DR",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342663839",
            "telephone_number": "863-993-2966",
            "fax_number": "863-494-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "22418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.