Individual provider Active NPI

Rebecca Labandeira, PT

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1124175880
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 33372 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3305
Phone
(559) 256-5200
Fax
(559) 256-5376
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

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 33372 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3305

Mailing address

1630 E Herndon Ave
Fresno, CA 93720-3305
Phone (559) 256-5200

Other identifiers 1

IdentifierTypeStateIssuer
0218271OtherCASTATE OF WASHINGTON

Other names 1

  • Rebecca Witt Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080616000794 CA Practitioner - Physical Therapist in Private Practice 5193896322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 290-7051

2335 E Kashian LN
Fresno, CA 93701-2234

Merit-based Incentive Payment System (MIPS)

Final score
90.41 of 100Reported as group
Quality
87.02
Promoting interoperability
100
Improvement activities
40
Cost
78.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 33372CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Sierra Pacific Orthopaedic Center Medical Group, Inc. CurrentSince May 1, 2008 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
Community Foundation Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Sierra Pacific Orthopaedic Center Medical Group Inc CurrentSince May 1, 2008 Accepting new patients

Locations

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Interoperability endpoints

  • Direct secure messaging: rebecca.labandeirapt.p1@direct.spocortho.nextgenshare.com

Organizations & group practices 5

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124175880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABANDEIRA",
        "first_name": "REBECCA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 33372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WASHINGTON",
            "identifier": "0218271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WITT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fresno, 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.
  • 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.