Active NPI
Rancho Physical Therapy, Inc.
- Physical Therapist
- Perris, CA
National Provider Identifier
1023086790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- RANCHO PHYSICAL THERAPY, INC.
- Practice address
- 126 Avocado Ave
Ste 107
Perris, CA 92571-2605 - Phone
- (951) 943-8105
- Fax
- (951) 943-8106
- NPI assigned
- Mar 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gabriela Litt
- Title
- Credentialing
- Phone
- (951) 696-9353
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
126 Avocado Ave
Ste 107
Perris, CA 92571-2605
Mailing address
600 Central Ave Ste C
Lake Elsinore, CA 92530-2740
Phone (951) 696-9353
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023086790 | Medicaid | CA | |
| ZZZ60928Z | Other | CA | BLUE SHIELD |
Other names 1
- Rancho Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Other NPIs on the same Medicare enrollment 13
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Physical Therapist
- Rancho Cucamonga, CA
- NPI 1689905325
O20040127001225
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Los Angeles, CA
- NPI 1912606534
-
- Physical Therapist
- Somerville, MA
- NPI 1174249494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1647216000000",
"number": "1023086790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 CENTRAL AVE STE C",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925302740",
"telephone_number": "951-696-9353",
"fax_number": "951-973-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 AVOCADO AVE",
"address_2": "STE 107",
"city": "PERRIS",
"state": "CA",
"postal_code": "925712605",
"telephone_number": "951-943-8105",
"fax_number": "951-943-8106"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RANCHO PHYSICAL THERAPY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-09",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A",
"authorized_official_last_name": "LITT",
"authorized_official_first_name": "GABRIELA",
"authorized_official_title_or_position": "CREDENTIALING",
"authorized_official_telephone_number": "951-696-9353"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1023086790",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ60928Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rancho Physical Therapy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rancho Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.