Individual provider Active NPI

Irwin Maquiling

  • Physical Therapist
  • Roseville, CA
National Provider Identifier
1194507061
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303983 Issued in CA
Practice address
3169 Adelaide Loop
Roseville, CA 95747-4282
Phone
(847) 840-8808
NPI assigned
Oct 16, 2023
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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 303983 CA Primary

Addresses

Primary practice location

3169 Adelaide Loop
Roseville, CA 95747-4282

Mailing address

3169 Adelaide Loop
Roseville, CA 95747-4282
Phone (847) 840-8808

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
303983CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1194507061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 ADELAIDE LOOP",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474282",
            "telephone_number": "847-840-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 ADELAIDE LOOP",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957474282",
            "telephone_number": "847-840-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAQUILING",
        "first_name": "IRWIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.