Revital Duer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30187 Issued in CA

Practice address

3366 E Thousand Oaks Blvd
Thousand Oaks, CA 91362-3443

Phone

(805) 374-9900

Fax

(805) 374-9910

NPI assigned

Mar 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Group practices

Pro X Physical Therapy PCGroup PAC ID 0547508467, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pro X Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Agoura Hills, CA
  • NPI 1518441849
  Medicare reassignment Care Compare group NPD Authorized official
• Xcelerate Physical Therapy Inc.

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1306814124
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194794032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 E THOUSAND OAKS BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913623443",
            "telephone_number": "805-374-9900",
            "fax_number": "805-374-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 E THOUSAND OAKS BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913623443",
            "telephone_number": "805-374-9900",
            "fax_number": "805-374-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUER",
        "first_name": "REVITAL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD IDENTIFIER",
            "identifier": "OPT301870",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP IDENTIF",
            "identifier": "ZZZ082282",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DRS Griffith and Hamlet Optometrists
• Maria Dubovitskaya, MD
• Brock W Dudley, DC
• Paul L. Dudley, M.D.
• Quinn Sierra Dudley
• Jean Marie Duffy, D. C.
• Shannon E. Duncan, BCBA
• Heidi Michelle Duque, P.T.
• Cynthia J Duran de la Torre
• Giselle Angelica Duran Farfan, LMFT

• Physical Therapist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.