Individual provider Active NPI

Alejandro Quezada, DPT

  • Physical Therapist
  • Pomona, CA
National Provider Identifier
1194306746
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299049 Issued in CA
Practice address
1902 Royalty Dr Ste 220
Pomona, CA 91767-3056
Phone
(909) 622-0006
Fax
(909) 622-0007
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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 299049 CA Primary

Addresses

Primary practice location

1902 Royalty Dr Ste 220
Pomona, CA 91767-3056

Mailing address

1845 Business Center Dr Ste 127
San Bernardino, CA 92408-3434
Phone (909) 890-9030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615003706 CA Practitioner - Physical Therapist in Private Practice 9436559291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Therapy Network IncorporatedGroup PAC ID 9234022369, 22 clinicians

Practice addresses (Care Compare)

1902 Royalty Dr
Suite 220
Pomona, CA 91767-3056
Phone (909) 622-0006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299049CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Therapy Network Incorporated Physical Therapist Current Accepting new patients
United Therapy Network Incorporated Physical Therapist CurrentSince Feb 23, 2021 Accepting new patients
United Therapy Network Incorporated Physical Therapist CurrentSince Feb 23, 2021 Accepting new patients

Locations

1902 Royalty Dr
Ste 220
Pomona, CA 91767
Phone (909) 570-3108

10470 Foothill Blvd
Ste 101
Rancho Cucamonga, CA 91730
Phone (909) 948-0411

1845 Business Center Dr
Ste 127
Sn Bernrdno, CA 92408
Phone (909) 890-9030

100 N Barranca St
Ste 380
West Covina, CA 91791
Phone (626) 331-8355

Organizations & group practices 3

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1194306746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 ROYALTY DR STE 220",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673056",
            "telephone_number": "909-622-0006",
            "fax_number": "909-622-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "ALEJANDRO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.