NPIMap

Organization Active NPI

Barbara Jean Boutelle/Carlsbad Physical Therapy

Doing business as Tri City Physical Therapy and Hand Center

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1003864414
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BARBARA JEAN BOUTELLE/CARLSBAD PHYSICAL THERAPY
Doing business as
Tri City Physical Therapy and Hand Center
Practice address
2067 W Vista Way
Ste. 185
Vista, CA 92083-6031
Phone
(760) 631-5888
Fax
(760) 631-5880
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Barbara Jean Boutelle, R.P.T
Title
Owner/Secretary
Phone
(760) 591-7750

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X CA Primary
Hand Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251H1200X CA
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X CA
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X CA

Addresses

Primary practice location

2067 W Vista Way
Ste. 185
Vista, CA 92083-6031

Mailing address

3070 Madison St
Carlsbad, CA 92008-2310
Phone (760) 591-7750

Other names 1

  • Tri City Physical Therapy and Hand Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000823 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4082527189 Receives reassigned benefits from 32 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santee, CA; Vista, CA; San Marcos, CA; San Diego, CA; Ramona, CA; Oceanside, CA; Escondido, CA; Carlsbad, CA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Barbara Jean Boutelle Carlsbad Physical Therapy12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1003864414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MADISON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082310",
            "telephone_number": "760-591-7750",
            "fax_number": "760-294-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "STE. 185",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-631-5888",
            "fax_number": "760-631-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARBARA JEAN BOUTELLE/CARLSBAD PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "BOUTELLE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/SECRETARY",
        "authorized_official_telephone_number": "760-591-7750",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Hand",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri City Physical Therapy and Hand Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tri City Physical Therapy and Hand Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.