POS Therapy Reference Report
Line
Line Descriptions
Value
Type
POS Field
106517
PHYSIOTHERAPY ASSOCIATES
LAKE WORTH, FL 33467
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
02
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
05/02/2003
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00090
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
01/01/1977
PROV1565
00160
Date of Prior Change in Ownership
DATE
09/01/1993
PROV1615
00170
Prior Intermediary Number
CODE
51100
PROV1620
00180
Provider Number
CODE
106517
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
5619669273
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33467
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.25
PROV1050
00630
Physical Therapists
FTES
3.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
1.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
3.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
1.00
PROV1210
03730
106701
SELECT PHYSICAL THERAPY
BOCA RATON, FL 33486
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
11/18/2004
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00010
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
10/18/1988
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
00090
PROV1620
00180
Provider Number
CODE
106701
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
4077507633
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33486
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.00
PROV1050
00630
Physical Therapists
FTES
2.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
0.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
2.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
0.00
PROV1210
03730
106753
SELECT PHYSICAL THERAPY
JUPITER, FL 33477
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
05/18/2004
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00010
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
09/19/1990
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
00090
PROV1620
00180
Provider Number
CODE
106753
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
5617438890
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33477
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.00
PROV1050
00630
Physical Therapists
FTES
5.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
0.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
5.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
0.00
PROV1210
03730
106826
PHYSICAL THERAPY OF BOCA RATON
BOCA RATON, FL 33431
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
Compliance Based on Acceptable POC
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
03/22/1999
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00090
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
07/12/1993
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
51100
PROV1620
00180
Provider Number
CODE
106826
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
4073915844
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33431
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.00
PROV1050
00630
Physical Therapists
FTES
0.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
0.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
0.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
1.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
1.00
PROV1210
03730
106832
PROFESSIONAL TOUCH REHAB INC
DELRAY BEACH, FL 33445
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
Not In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
04/03/2002
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00090
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
11/02/1993
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
51100
PROV1620
00180
Provider Number
CODE
106832
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
4072650410
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33445
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.00
PROV1050
00630
Physical Therapists
FTES
1.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
1.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
1.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
1.00
PROV1210
03730
106854
SELECT PHYSICAL THERAPY
LAKE WORTH, FL 33461
A
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
07/20/2006
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
00010
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
05/20/1994
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
00090
PROV1620
00180
Provider Number
CODE
106854
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
4076420400
PROV1605
00270
Termination Reason Code
Active
PROV4770
00280
Termination Date/Expriation Date
DATE
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33461
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.50
PROV1050
00630
Physical Therapists
FTES
1.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
0.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
0.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
1.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
0.00
PROV1210
03730
106863
HORIZON PHYSICAL THERAPY
JUPITER, FL 33477
T
Subtype of provider
Short Term
PROV0085
00010
Category of Provider/Supplier
Outpat Phy Therapy/Speech
PROV0075
00020
Change of Ownership Counter
00
PROV0095
00030
Change of Ownership Date
DATE
PROV0100
00040
Provider has Correction Plan for Deficiencies
PROV0220
00060
Provider in Compliance with Correction Plan
In Compliance
PROV2715
00070
Provider County
490
PROV2695
00080
Old Provider Number for this Provider
CODE
PROV0300
00090
Current FMS Survey Date
DATE
PROV0500
00100
Official Survey Date
DATE
04/25/2007
PROV2740
00110
Eligibility for Medicare/Mediciad
Yes
PROV0455
00120
Intermediary/Carrier Servicing Provider
52280
PROV0605
00140
Medicare/Medicaid Vendor Number
CODE
PROV0655
00150
Date Approved for Medicare/Medicaid
DATE
10/24/1994
PROV1565
00160
Date of Prior Change in Ownership
DATE
PROV1615
00170
Prior Intermediary Number
CODE
PROV1620
00180
Provider Number
CODE
106863
PROV1680
00190
Current Status of Record
Accepted
PROV1720
00200
CMS Regional Office for Provider
Atlanta
PROV1725
00210
Skeleton Record Indicator
PROV2045
00220
Provider State
FL
PROV3230
00230
SSA State Code
10
PROV2700
00240
State Region Code (in selected states)
LAN
PROV2710
00250
Provider Telephone Number
5616260991
PROV1605
00270
Termination Reason Code
Voluntary - Merge,Close
PROV4770
00280
Termination Date/Expriation Date
DATE
10/19/2007
PROV4500
00290
Type of Action for Transmittal
Recertification
PROV2880
00300
Type of Control for Provider
Proprietary
PROV2885
00310
Provider Zip Code
33477
PROV2905
00320
Provider FIPS State
12
FIPSTATE
00330
Provider FIPS County
12099
FIPCNTY
00340
SSA MSA Code
637
SSAMSACD
00350
SSA MSA Size Code
C
SSAMSASZ
00360
Fiscal Year Ending Month/Day
1231
PROV0485
00570
Occupational Therapists
FTES
0.00
PROV1050
00630
Physical Therapists
FTES
2.00
PROV1125
00660
Type of Facility
0804
PROV2890
01590
Related Provider Number
CODE
PROV1755
02560
Speech Pathologists & Audiologists
FTES
0.00
PROV1220
03520
Physical Therapist - Arrangement
FTES
1.00
PROV1105
03700
Physical Therapist - Full Time / On Stall
FTES
1.00
PROV1120
03710
Speech Pathologists - Arrangement
FTES
0.00
PROV1215
03720
Speech Pathologists - Full Time / On Stall
FTES
0.00
PROV1210
03730
6/10/2008
11:45:39AM
C
:
\
DOCUME
~
1
\
ROBERT
~
1
\
LOCALS
~
1
\
Temp
\
temp
_
c
7
e
681
c
1
-
b
2
d
6
-
4
e
6
e
-
a
764
-
c
5
db
71
c
5
b
719
{
23
F
435
B
3
-
B
195
-
4
A
1
C
-
88
AA
-
49
BBE
0
B
7
B
87
F
}
.
rpt
Page 7 of 7
11:45 am
www
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6/10/2008
Healthcare Almanac
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228
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