Individual provider Active NPI

Joshua Perez, PT, DPT

  • Physical Therapist
  • Reno, NV
National Provider Identifier
1033687066
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4388 Issued in NV
Practice address
1610 Robb Dr Ste D5
Reno, NV 89523-3520
Phone
(775) 746-9222
Fax
(775) 746-9224
NPI assigned
Nov 7, 2018
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4388 NV Primary
Physical Therapist 225100000X PT013768 GA

Addresses

Primary practice location

1610 Robb Dr Ste D5
Reno, NV 89523-3520

Mailing address

1450 E Prater Way Ste 103
Sparks, NV 89434-8973
Phone (775) 331-1199

Other practice location 1

863 W Oglethorpe Hwy Ste 210
Hinesville, GA 31313-4491
Phone (912) 368-0534

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212000818 NV Practitioner - Physical Therapist in Private Practice 2769728062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013768GAMDPhysical Therapist
4388NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Custom Physical Therapy Limited Partnership Physical Therapist CurrentSince Oct 31, 2022 Accepting new patients
Custom Physical Therapy Limited Partnership Physical Therapist PastSince Sep 20, 2020 Accepting new patients

Locations

1610 Robb Dr
Ste D5
Reno, NV 89523
Phone (775) 746-9222

440 E Golden Valley Rd
Ste Ab
Reno, NV 89506
Phone (775) 360-3000

1450 E Prater Way
Ste 103
Sparks, NV 89434
Phone (775) 331-1199

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1033687066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 E PRATER WAY STE 103",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894348973",
            "telephone_number": "775-331-1199",
            "fax_number": "775-331-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 ROBB DR STE D5",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895233520",
            "telephone_number": "775-746-9222",
            "fax_number": "775-746-9224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "863 W Oglethorpe Hwy Ste 210",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313134491",
            "country_code": "US",
            "telephone_number": "912-368-0534",
            "fax_number": "912-368-0537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOSHUA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4388",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.