Active NPI
Phillip Daniel Herel, DPT
- Physical Therapist
- Palm Desert, CA
National Provider Identifier
1093198145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 42569
- Practice address
- 73010 El Paseo Ste B
Palm Desert, CA 92260-4248 - Phone
- (442) 234-5364
- NPI assigned
- Jul 8, 2015
- Last updated
- Feb 1, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | 42569 | CA | Primary |
Addresses
Primary practice location
73010 El Paseo Ste B
Palm Desert, CA 92260-4248
Mailing address
50760 Nectareo
La Quinta, CA 92253-8542
Phone (310) 625-0505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150811003687 | CA | Practitioner - Physical Therapist in Private Practice | 9032424791 | Practice locations: Palm Desert, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- State University of New York at Stony Brook, School of Medicine, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
73010 El Paseo
Suite 2B
Palm Desert, CA 92260-4281
Phone (442) 234-5364
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42569 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1093198145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50760 NECTAREO",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922538542",
"telephone_number": "310-625-0505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73010 EL PASEO STE B",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922604248",
"telephone_number": "442-234-5364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREL",
"first_name": "PHILLIP",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-08",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "42569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.