Robert Behyad Baniasadi, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

10280 Issued in CA

Practice address

612 E Janss Rd
Thousand Oaks, CA 91360-5113

Phone

(805) 373-0725

Fax

(805) 373-0574

NPI assigned

Jan 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bobby Baniasadi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: robert.baniasadi.p1@direct.lakeside.nextgenshare.com

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1124564067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8510 BALBOA BLVD",
            "address_2": "STE 150",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913253583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605113",
            "telephone_number": "805-373-0725",
            "fax_number": "805-373-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIASADI",
        "first_name": "ROBERT",
        "middle_name": "BEHYAD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBY",
            "last_name": "BANIASADI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapy Assistant in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.