Active NPI
Ryan Michael Rey Raroque, DPT
- Physical Therapist
- Beverly Hills, CA
National Provider Identifier
1053948018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 298270
- Practice address
- 9675 Brighton Way Ste 250
Beverly Hills, CA 90210-5180 - Phone
- (310) 278-5337
- NPI assigned
- Mar 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 298270 | CA | Primary |
Addresses
Primary practice location
9675 Brighton Way Ste 250
Beverly Hills, CA 90210-5180
Mailing address
4543 Conchita Way
Tarzana, CA 91356-4903
Phone (818) 943-0051
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
| License | State | Type | Specialty |
|---|---|---|---|
| 298270 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1053948018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4543 CONCHITA WAY",
"city": "TARZANA",
"state": "CA",
"postal_code": "913564903",
"telephone_number": "818-943-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9675 BRIGHTON WAY STE 250",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902105180",
"telephone_number": "310-278-5337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAROQUE",
"first_name": "RYAN MICHAEL",
"middle_name": "REY",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-26",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "298270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.