NPIMap

Organization Active NPI

Taos Physical Therapy, Inc.

  • Physical Therapist
  • Taos, NM
National Provider Identifier
1205934619
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TAOS PHYSICAL THERAPY, INC.
Practice address
414 Sipapu Street
Taos, NM 87571-6498
Phone
(575) 758-8761
Fax
(575) 751-0448
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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

Authorized official

Name
Alicia B. Esparza, P.T.NPI 1720181506
Title
Physical Therapist
Phone
(575) 758-8761

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

414 Sipapu Street
Taos, NM 87571-6498

Mailing address

6955 Ndcbu
Taos, NM 87571-6498
Phone (575) 758-8761

Other identifiers 1

IdentifierTypeStateIssuer
N5566MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051110000712 NM Part B Supplier - Clinic/Group Practice 9335167089 Receives reassigned benefits from 5 practitioners
Practice locations: Taos, NM

National Provider Directory

National Provider Directory

Locations

414 Sipapu St
Taos, NM 87571
Phone (505) 758-8761

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1205934619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6955 NDCBU",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716498",
            "telephone_number": "575-758-8761",
            "fax_number": "575-751-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SIPAPU STREET",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716498",
            "telephone_number": "575-758-8761",
            "fax_number": "575-751-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "ESPARZA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "575-758-8761",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N5566",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.