Individual provider Active NPI

Maesperanza So Herrera, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1144573692
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 30006 Issued in CA
Practice address
6400 66TH Ave
Apt.25
Sacramento, CA 95823-2735
Phone
(310) 619-8065
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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 30006 CA Primary

Addresses

Primary practice location

6400 66TH Ave
Apt.25
Sacramento, CA 95823-2735

Mailing address

6400 66TH Ave
Apt.25
Sacramento, CA 95823-2735
Phone (310) 619-8065

Other names 1

  • Maesperanza Baladad So Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210211003191 CA Practitioner - Physical Therapist in Private Practice 2860807468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1535 River Park Dr
Suite 1000
Sacramento, CA 95815-4601
Phone (916) 286-1000

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 30006CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Feb 24, 2021 Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

1535 River Park Dr
Ste 1000
Sacramento, CA 95815
Phone (916) 286-1000

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

4860 Y St
Ste 1700
Sacramento, CA 95817
Phone (916) 734-2700

Organizations & group practices 2

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": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1144573692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 66TH AVE",
            "address_2": "APT.25",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232735",
            "telephone_number": "310-619-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 66TH AVE",
            "address_2": "APT.25",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232735",
            "telephone_number": "310-619-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "MAESPERANZA",
        "middle_name": "SO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 30006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAESPERANZA",
            "last_name": "SO",
            "middle_name": "BALADAD",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 22, 2012; 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.