Individual provider Active NPI

Diane Marie Stinson-Roberts, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1013252238
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17475 Issued in CA
Practice address
5128 Fredericksburg Way
Sacramento, CA 95835-1337
Phone
(916) 396-5558
NPI assigned
Nov 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17475 CA Primary

Addresses

Primary practice location

5128 Fredericksburg Way
Sacramento, CA 95835-1337

Mailing address

5128 Fredericksburg Way
Sacramento, CA 95835-1337
Phone (916) 396-5558

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150326000076 CA Practitioner - Physical Therapist in Private Practice 4789901083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capuchino Therapy GroupGroup PAC ID 2860554839, 5 clinicians

Practice addresses (Care Compare)

3601 Marconi Ave
Sacramento, CA 95821-5309
Phone (916) 481-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17475CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capuchino Therapy Group CurrentSince Sep 1, 2022 Accepting new patients

Locations

9580 Oak Avenue Pkwy
Ste 7118
Folsom, CA 95630

3601 Marconi Ave
Sacramento, CA 95821
Phone (916) 481-1300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1013252238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5128 FREDERICKSBURG WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351337",
            "telephone_number": "916-396-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5128 FREDERICKSBURG WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958351337",
            "telephone_number": "916-396-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINSON-ROBERTS",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "17475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.