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Deactivated NPI 1043815392 Deactivated / Inactive NPI

Boost Pt

Physical Therapist • Saint Augustine, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Boost Pt has officially deactivated this NPI record and ceased active healthcare operations.

Registration / Start Date December 03, 2020
NPI Deactivation Date May 23, 2025
Total Practice Duration ~5 Years of Practice (2020 – 2025)

About Boost Pt NPI 1043815392 Summary

Boost Pt was a registered healthcare organization specializing in Physical Therapist located in Saint Augustine, FL. Operating from its primary practice location at 150 SOUTHPARK BLVD STE 204D, the facility provided medical services under NPI record 1043815392 prior to official deactivation on May 23, 2025.

Administrative records indicate Mitchell Gerald Barros as the registered authorized official.

Facility Location & Contact Primary Location

Facility Address

150 Southpark Blvd Ste 204d

Saint Augustine, FL 320865179

Telephone 9047701481

Authorized Official Information

Authorized Contact Name

Mitchell Gerald Barros

Official Telephone

9043152881

Facility Classifications & Specialties

Physical Therapist Primary Taxonomy

NUCC Taxonomy Code: 225100000X

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: 1.Diagnose and manage movement dysfunction and enhance physical and functional abilities. 2.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. 3.Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries. 4.Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems. 5.Address the negative effects attributable to unique personal and environmental factors as they relate to human performance. 6.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.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events
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NPI Profile Deactivated May 23, 2025

Record deactivated on May 23, 2025

NPI Profile Active December 10, 2020

NPI status registered as active in NPPES database

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Updated Practice Location December 10, 2020

Registered at 150 SOUTHPARK BLVD STE 204D, SAINT AUGUSTINE, FL 320865179 (Tel: 9047701481)

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Updated Business Mailing Address December 10, 2020

Registered at 1093 A1A BEACH BLVD # 198, SAINT AUGUSTINE, FL 320806733 (Tel: 9047701481)

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Organization / Clinic Name Updated December 10, 2020

Operating as BOOST PT

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2020

Physical Therapist

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Initial NPI Registration & Enumeration December 03, 2020

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1043815392
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: December 03, 2020
Last Update: December 10, 2020
Deactivation Date: May 23, 2025

Mailing Address

1093 A1a Beach Blvd # 198

Saint Augustine, FL 320806733

Phone: 9047701481

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.