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JEREMY SHAKOURI WYDRA
NPI 1497480792
Physical Therapist - Orthopedic in Winter Garden, FL

Active since July 20, 2022Accepts Medicare Assignment
4040 WINTER GARDEN VINELAND RD, WINTER GARDEN, FL 34787(407) 573-3361(407) 395-8309 Get Directions Write a Review

NPPES record last updated: June 7, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 7, 2023, Feb 7, 2023, Jul 20, 2022 (3 updates tracked since 2022).

About Jeremy Shakouri Wydra NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY SHAKOURI WYDRA (NPI 1497480792) is an individual orthopedic provider in Winter Garden, Florida, licensed in Florida (PT39007) and active in the NPI registry since July 2022. He is a graduate of Other (2022).

NPPES Registry Identity

NPI1497480792
Entity TypeIndividualMale
Primary Taxonomy2251X0800X
Provider Legal NameJEREMY SHAKOURI WYDRA
Location Address4040 WINTER GARDEN VINELAND RDWinter Garden, FL 34787-9502
Mailing Address4040 Winter Garden Vineland RdWinter Garden, FL 34787-9502 · (407) 573-3361 · Fax (407) 395-8309
Phone(407) 573-3361
Fax(407) 395-8309
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 20, 2022
Last NPPES UpdateJune 7, 20233 updates tracked since enumeration
NPPES CertifiedJune 7, 2023
✔ NPI 1497480792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in FL · PT39007
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
Also ListedPhysical TherapistTaxonomy 225100000X · License 29148 (MD)
4040 WINTER GARDEN VINELAND RD, Winter Garden, FL 34787
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Oscar Health Maintenance Organization of Florida.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jeremy Shakouri Wydra is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931585957
PECOS Enrollment IDI20230630003218

Medicare Billing Reassignments

3

Medicare enrollment records show Jeremy Wydra reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orlando Health Medical Group Inc
13 mi
Internal Medicine
52 W UNDERWOOD ST
Orlando, FL 32806
  • Reassigned Medicare billing, Florida enrollment
  • 3,290 clinicians in this Medicare group
NPI 1669429577 (321) 841-2452
University Of Central Florida
24 mi
Family Medicine
3400 QUADRANGLE BLVD
Orlando, FL 32817
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: The University Of Central Florida Board Of Trustees
  • 66 clinicians in this Medicare group
NPI 1104066216 (407) 266-3627
Florida Luna Care Physical Therapy LLC
120 mi
Physical Therapist
5011 GATE PKWY STE 100
Jacksonville, FL 32256
  • Reassigned Medicare billing, Florida enrollment
  • 422 clinicians in this Medicare group
NPI 1114542032 (866) 525-3175

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JULI LYNN WILLIAMS PT
Physical Therapist
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
GINA MARIE HEINTSKILL
Physical Therapist
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
DR. RICHARD WILKIN THOM PT, DPT
Physical Therapist (Orthopedic)
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
JAMES GERARD TURCER PT
Physical Therapist (Orthopedic)
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
CAROLINE DE OLIVEIRA MICHELSON PT
Physical Therapist
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
RISHI GARIB PT
Physical Therapist (Orthopedic)
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
SAMANTHA PETERS PT
Physical Therapist
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361
TYLER MOK
Physical Therapist
4040 WINTER GARDEN VINELAND RD
WINTER GARDEN, FL 34787
Orange County (407) 573-3361

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremy Wydra's NPI number?

The NPI number for Jeremy Wydra is 1497480792. It was assigned to this individual provider in the NPPES registry on July 20, 2022.

Where is Jeremy Wydra located?

Jeremy Wydra practices at 4040 Winter Garden Vineland Rd, Winter Garden, FL 34787. The listed phone number is (407) 573-3361.

What is Jeremy Wydra's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Jeremy Wydra enrolled in Medicare?

Yes. Jeremy Wydra is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jeremy Wydra's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Wydra reassigns Medicare benefits to 3 organizations: Orlando Health Medical Group Inc (Orlando, FL), University Of Central Florida (Orlando, FL) and Florida Luna Care Physical Therapy LLC (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeremy Wydra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeremy Wydra accept?

Health plans from AmeriHealth Caritas Next and Oscar Health Maintenance Organization of Florida list Jeremy Wydra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeremy Wydra was last updated on June 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.