Individual provider Active NPI

Christian Charles Robertozzi, PT, DPT, OCS

  • Orthopedic Physical Therapist
  • Bentonville, AR
National Provider Identifier
1093153173
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT4240 Issued in AR
Practice address
907 SE Village Loop Ste 5
Bentonville, AR 72712-2229
Phone
(479) 402-9400
Fax
(479) 431-5098
NPI assigned
Jun 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT4240 AR Primary

Addresses

Primary practice location

907 SE Village Loop Ste 5
Bentonville, AR 72712-2229

Mailing address

907 SE Village Loop Ste 5
Bentonville, AR 72712-2229
Phone (479) 268-6040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170901001049 AR Practitioner - Physical Therapist in Private Practice 9931400207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bentonville Physical Therapy SpecialistsGroup PAC ID 7911270582, 2 clinicians

Practice addresses (Care Compare)

907 SE Village Loop
Suite 5
Bentonville, AR 72712-2229
Phone (479) 402-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4240ARMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Advanced Medicine, PA PastSince Jun 26, 2017 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1093153173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 SE VILLAGE LOOP STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727122229",
            "telephone_number": "479-268-6040",
            "fax_number": "479-431-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 SE VILLAGE LOOP STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727122229",
            "telephone_number": "479-402-9400",
            "fax_number": "479-431-5098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTOZZI",
        "first_name": "CHRISTIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AR",
            "license": "PT4240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.