Antoinette Vastenburg, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3608 Issued in CO

Practice address

4150 Darley Ave
Suite8
Boulder, CO 80305-6557

Phone

(303) 494-4100

NPI assigned

Mar 14, 2007

Last updated

Mar 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Solutions Physical Therapy, P.C.Group PAC ID 8224011721, 3 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Active Solutions Physical Therapy, P.C.

  • Physical Therapy Clinic/Center
  • Boulder, CO
  • NPI 1013940808
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1205960234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 GOLD RUN RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803028743",
            "telephone_number": "303-447-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DARLEY AVE",
            "address_2": "SUITE8",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056557",
            "telephone_number": "303-494-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASTENBURG",
        "first_name": "ANTOINETTE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "3608",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CO",
            "license": "3608",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64770095",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doris Vargas
• Margaret Varner, N.P.
• Tim Varner, TIM VARNER, LCSW
• Leane Marie Vasquez
• Susan Vastano, RPH
• Whitney Vaught
• Raymond Vavrik Jr.
• Carly Vayre, RN
• Vedana Whole Being Therapy, LLC
• Jason Merce Vela

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.