Individual provider Active NPI

Daniel Ryan Blanchard

  • Physical Therapist
  • Walnut Creek, CA
National Provider Identifier
1104462852
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41727 Issued in CA
Practice address
2255 Ygnacio Valley Rd
Walnut Creek, CA 94598-3343
Phone
(925) 930-6680
NPI assigned
Nov 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 PT41727 CA Primary

Addresses

Primary practice location

2255 Ygnacio Valley Rd
Walnut Creek, CA 94598-3343

Mailing address

1929 Rose St
Berkeley, CA 94709-1961
Phone (831) 295-3937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116000000 CA Practitioner - Physical Therapist in Private Practice 2668807835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor and Thornburg Physical Therapy, Inc.Group PAC ID 4789753880, 11 clinicians

Practice addresses (Care Compare)

3718 Grand Ave
Suite 15
Oakland, CA 94610-1544
Phone (510) 893-8878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41727CAMDPhysical Therapist

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1104462852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 ROSE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091961",
            "telephone_number": "831-295-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983343",
            "telephone_number": "925-930-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "DANIEL",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT41727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.