Individual provider Active NPI

Tyler Torres, PT, DPT

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1225583487
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291821 Issued in CA
Practice address
1917 Coffee Rd
Modesto, CA 95355-2704
Phone
(209) 549-4626
Fax
(209) 549-4625
NPI assigned
Aug 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5537 ME
Physical Therapist 225100000X 291821 CA Primary

Addresses

Primary practice location

1917 Coffee Rd
Modesto, CA 95355-2704

Mailing address

5292 Sherwood CT
Atwater, CA 95301-6273
Phone (209) 769-8733

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
291821CAMDPhysical Therapist
5537MEMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1225583487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5292 SHERWOOD CT",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953016273",
            "telephone_number": "209-769-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552704",
            "telephone_number": "209-549-4626",
            "fax_number": "209-549-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-17",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "5537",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.