Individual provider Active NPI

Carolyn T Peretti, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1124209861
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5117 Issued in CA
Practice address
7551 Timberlake Way
Suite 200
Sacramento, CA 95823
Phone
(916) 691-0446
Fax
(916) 691-9146
NPI assigned
Nov 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 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 PT5117 CA Primary

Addresses

Primary practice location

7551 Timberlake Way
Suite 200
Sacramento, CA 95823

Mailing address

PO Box 232330
Sacramento, CA 95823-0422
Phone (916) 691-0446

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051013000819 CA Practitioner - Physical Therapist in Private Practice 3375568785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7551 Timberlake Way
Suite 200
Sacramento, CA 95823-5422
Phone (916) 691-0446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5117CAMDPhysical Therapist
5117CAMDMassage 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": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1124209861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232330",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958230422",
            "telephone_number": "916-691-0446",
            "fax_number": "916-691-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 TIMBERLAKE WAY",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95823",
            "telephone_number": "916-691-0446",
            "fax_number": "916-691-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERETTI",
        "first_name": "CAROLYN",
        "middle_name": "T",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT5117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.