Individual provider Active NPI

Christian Quijano, DPT

  • Physical Therapist
  • Los Alamos, NM
National Provider Identifier
1154895506
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5437 Issued in NM
Practice address
1350 Central Ave Ste 105
Los Alamos, NM 87544-6217
Phone
(505) 662-3384
NPI assigned
Jan 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0015893 CO
Physical Therapist 225100000X 5437 NM Primary

Addresses

Primary practice location

1350 Central Ave Ste 105
Los Alamos, NM 87544-6217

Mailing address

1350 Central Ave Ste 105
Los Alamos, NM 87544-6217
Phone (505) 662-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0015893COMDPhysical Therapist
5437NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PTP Inc Physical Therapist PastSince Oct 13, 2019 Accepting new patients
Physical Therapy Plus Inc Physical Therapist PastSince Dec 29, 2017 Accepting new patients

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1154895506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 CENTRAL AVE STE 105",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875446217",
            "telephone_number": "505-662-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CENTRAL AVE STE 105",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875446217",
            "telephone_number": "505-662-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-18",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0015893",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "5437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.