SOS PHYSIO LLC – Sports Medicine (Family Medicine) Physician, NPI 1285091942
Sports Medicine (Family Medicine) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SOS PHYSIO LLC
Northeast 207th Street, Aventura, Miami-Dade County, Florida, 33180, United States
AVENTURA, FL 331803705
Phone: (305) 306-8376
Fax: (305) 306-8373
Type: Mailing
3990 Sheridan St Ste 104
Hollywood, FL 330213655
Phone: (305) 306-8376
Fax: (954) 633-7632
Type: Location
935 Arthur Godfrey Rd
Miami Beach, FL 331403306
Phone: (305) 306-8376
Fax: (305) 402-4336
Type: Location
4410 W 16th Ave Ste 48
Hialeah, FL 330127193
Phone: (305) 306-8376
Fax: (305) 570-2148
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-07-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (799 days ago).
Enrollment records
2
Earliest due date
2024-03-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20160502001171 | O | Clinic/Group Practice | FL | 2024-03-31 |
| O20170718000143 | O | Independently-Practicing Physical Therapist | FL | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33180)
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