Jeremy Shakouri Wydra, in Winter Garden, FL - Medicare Physical Therapist Provider

Jeremy Shakouri Wydra, is a medicare enrolled "Physical Therapist - Orthopedic" provider in Winter Garden, Florida. His current practice location is 4040 Winter Garden Vineland Rd, Winter Garden, Florida. You can reach out to his office (for appointments etc.) via phone at (407) 573-3361.

Jeremy Shakouri Wydra is licensed to practice in Florida (license number PT39007) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497480792.

Contact Information

	Jeremy Shakouri Wydra,
	4040 Winter Garden Vineland Rd, Winter Garden, FL 34787-9502
	(407) 573-3361
	(407) 395-8309

Map and Direction

Healthcare Provider's Profile

Full Name	Jeremy Shakouri Wydra
Gender	Male
Speciality	Physical Therapist - Orthopedic
Location	4040 Winter Garden Vineland Rd, Winter Garden, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1497480792
Provider Enumeration Date: 07/20/2022
Last Update Date: 06/07/2023

Medicare PECOS Information:

PECOS PAC ID: 9931585957
Enrollment ID: I20220928002997

Medical Identifiers

Medical identifiers for Jeremy Shakouri Wydra such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497480792	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	(* (Not Available))	Secondary
225100000X	Physical Therapist	29148 (Maryland)	Secondary
2251X0800X	Physical Therapist - Orthopedic	PT39007 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jeremy Shakouri Wydra allows following entities to bill medicare on his behalf.

Provider Name	Maryland Sportscare & Rehab Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1518951995 PECOS PAC ID: 2860440427 Enrollment ID: O20151113000065

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeremy Shakouri Wydra is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jeremy Shakouri Wydra, 4040 Winter Garden Vineland Rd, Winter Garden, FL 34787-9502 Ph: (407) 573-3361	Jeremy Shakouri Wydra, 4040 Winter Garden Vineland Rd, Winter Garden, FL 34787-9502 Ph: (407) 573-3361

Reviews and Comments

Physical Therapist in Winter Garden, FL

Pediatric Therapy Services Of Greater Orlando, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 S West Crown Pointe Rd, Suite 150, Winter Garden, FL 34787 Phone: 407-905-8905 Fax: 407-905-8958
Ms. Juli Lynn Williams, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4040 Winter Garden Vineland Rd, Winter Garden, FL 34787 Phone: 407-573-3361 Fax: 407-395-8309
Robert Ryan Simons, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 15526 Lake Burnett Shore Ct, Winter Garden, FL 34787 Phone: 407-227-0984
Horizons Therapy Services Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11066 Suspense Dr, Winter Garden, FL 34787 Phone: 407-280-4916
Elevate Physical Therapy, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 3554 W Orange Country Club Dr Ste 230, Winter Garden, FL 34787 Phone: 612-325-6126
Dr. Richard Wilkin Thom, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4040 Winter Garden Vineland Rd, Winter Garden, FL 34787 Phone: 407-573-3361 Fax: 407-395-8309
Jeremiah Bradford, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 14215 W Colonial Dr, Winter Garden, FL 34787 Phone: 407-595-8962

Jeremy Shakouri Wydra, - Medicare Physical Therapist in Winter Garden, FL