ACTIVE FOR LIFE REHABILITATION, LLC
NPI 1639410384
Physical Therapist in Saint Johns, FL

Active since March 05, 2013
4164 LONICERA LOOP, SAINT JOHNS, FL 32259(904) 891-1179(904) 212-1202 Get Directions Write a Review

NPPES record last updated: July 21, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Active For Life Rehabilitation, Llc NPPES

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

ACTIVE FOR LIFE REHABILITATION, LLC (NPI 1639410384) is a healthcare organization registered as a physical therapist in Saint Johns, Florida and active in the NPI registry since March 2013. The organization lists Geoffrey Graeme Angell, Manager, as its authorized official.

NPPES Registry Identity

NPI1639410384
Entity TypeOrganization
Primary Taxonomy225100000X
Legal Business NameACTIVE FOR LIFE REHABILITATION, LLC
Location Address4164 LONICERA LOOPSaint Johns, FL 32259-4531
Mailing Address4164 Lonicera LoopSaint Johns, FL 32259-4531 · (904) 891-1179
Fax(904) 212-1202
Organization SubpartNo
Authorized OfficialGeoffrey Graeme AngellManager · (904) 891-1179
Enumeration DateMarch 5, 2013
Last NPPES UpdateJuly 21, 2014
✔ NPI 1639410384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
License✔ Licensed in FL · PT 21700
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
4164 LONICERA LOOP, Saint Johns, FL 32259

Other Identifiers 2

Medicaid010501000FL
Medicare PINHD565A

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Active For Life Rehabilitation, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20130510000142Non-DME Part B · Physical/Occupational Therapy Group in Private PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Active For Life Rehabilitation, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Physical Therapist in Private Practice
NPI 1457691065
4164 LONICERA LOOP
Saint Johns, FL 32259
(904) 891-1179
✔ Accepts MedicareSame address

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

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 Active For Life Rehabilitation, LLC's NPI number?

The NPI number for Active For Life Rehabilitation, LLC is 1639410384. It was assigned to this organization in the NPPES registry on March 5, 2013.

Where is Active For Life Rehabilitation, LLC located?

Active For Life Rehabilitation, LLC is located at 4164 Lonicera Loop, Saint Johns, FL 32259. The listed phone number is (904) 891-1179.

What is Active For Life Rehabilitation, LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Active For Life Rehabilitation, LLC enrolled in Medicare?

Yes. Active For Life Rehabilitation, LLC is registered in the Medicare PECOS enrollment system.

When is Active For Life Rehabilitation, LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Physical/Occupational Therapy Group in Private Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Active For Life Rehabilitation, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Active For Life Rehabilitation, LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Active For Life Rehabilitation, LLC was last updated on July 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.