NPIMap

Organization Active NPI

Rancho Physical Therapy, Inc.

Doing business as Rancho Physical Therapy

  • Physical Therapist
  • Lake Elsinore, CA
National Provider Identifier
1043288632
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RANCHO PHYSICAL THERAPY, INC.
Doing business as
Rancho Physical Therapy
Practice address
600 Central Ave Ste C
Lake Elsinore, CA 92530-2740
Phone
(951) 696-9353
Fax
(951) 973-7216
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Gabriela Litt
Title
Provider Relations Supervisor
Phone
(951) 696-9353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X CA Primary

Addresses

Primary practice location

600 Central Ave Ste C
Lake Elsinore, CA 92530-2740

Mailing address

600 Central Ave Ste C
Lake Elsinore, CA 92530-2740
Phone (951) 696-9353

Other names 1

  • Rancho Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127001225 CA Part B Supplier - Clinic/Group Practice 2365346491 Receives reassigned benefits from 40 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Murrieta, CA; Victorville, CA; Temecula, CA; Riverside, CA; Rancho Cucamonga, CA; Perris, CA; Moreno Valley, CA; Menifee, CA…

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

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": "1043288632",
    "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": "600 CENTRAL AVE STE C",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302740",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        }
    ],
    "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": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "951-696-9353"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Lake Elsinore, 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.

Verify at the official NPI Registry.