Individual provider Active NPI

Anthony Paul Carrasco, P.T.

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1053512806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 25822 Issued in CA
Practice address
2968 Laning Rd
San Diego, CA 92106-6434
Phone
(760) 743-2102
Fax
(760) 269-7427
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 25822 CA Primary

Addresses

Primary practice location

2968 Laning Rd
San Diego, CA 92106-6434

Mailing address

2968 Laning Road
San Diego, CA 92106-6434
Phone (760) 743-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25822CAMDClinical Social Worker
PT 25822CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Home Therapy Associates, Inc. Physical Therapist PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 1

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": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053512806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 LANING ROAD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066434",
            "telephone_number": "760-743-2102",
            "fax_number": "760-269-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 LANING RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066434",
            "telephone_number": "760-743-2102",
            "fax_number": "760-269-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCO",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 25822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.