Patrick Joseph Bagan, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

36243 Issued in CA

Practice address

3178 Hamner Ave # 4
Norco, CA 92860-1936

Phone

(951) 736-5646

Fax

(951) 736-5694

NPI assigned

Nov 24, 2009

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

• Patrick Joseph Medeiros-Bagan Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodybasics Physical Therapy IncGroup PAC ID 2365413861, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodybasics Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Norco, CA
  • NPI 1487651097
  Medicare reassignment Care Compare group NPD
• Bodybasics Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Corona, CA
  • NPI 1194904243
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1144558487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3178 HAMNER AVE # 4",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601936",
            "telephone_number": "951-736-5646",
            "fax_number": "951-736-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3178 HAMNER AVE # 4",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928601936",
            "telephone_number": "951-736-5646",
            "fax_number": "951-736-5694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGAN",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "36243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICK",
            "last_name": "MEDEIROS-BAGAN",
            "middle_name": "JOSEPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Orthopedic Physical Therapist in Norco, CA
• Providers in Norco, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.