Individual provider Active NPI

Jason Rico, PTA

  • Physical Therapy Assistant
  • Sherman Oaks, CA
National Provider Identifier
1194211912
Registry record updated Jul 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10527 Issued in CA
Practice address
4940 Van Nuys Blvd Ste 301
Sherman Oaks, CA 91403-1742
Phone
(818) 907-0952
Fax
(818) 990-9449
NPI assigned
Jul 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10527 CA Primary

Addresses

Primary practice location

4940 Van Nuys Blvd Ste 301
Sherman Oaks, CA 91403-1742

Mailing address

10851 Moorpark St Apt 7
North Hollywood, CA 91602-3924
Phone (310) 924-0783

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
10527CAMDClinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530662400000",
    "number": "1194211912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10851 MOORPARK ST APT 7",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916023924",
            "telephone_number": "310-924-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 VAN NUYS BLVD STE 301",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031742",
            "telephone_number": "818-907-0952",
            "fax_number": "818-990-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICO",
        "first_name": "JASON",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-04",
        "last_updated": "2018-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2018; 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.