Individual provider Active NPI

Timothy Tarrant

  • Physical Therapist
  • Lodi, CA
National Provider Identifier
1275309205
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305266 Issued in CA
Practice address
210 W Pine St
Lodi, CA 95240-2020
Phone
(209) 365-7867
NPI assigned
Nov 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 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 305266 CA Primary

Addresses

Primary practice location

210 W Pine St
Lodi, CA 95240-2020

Mailing address

9857 Tralee Way
Elk Grove, CA 95624-2650

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231215001077 CA Practitioner - Physical Therapist in Private Practice 2668821612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

210 W Pine St
Lodi, CA 95240-2020
Phone (209) 365-7867

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Nov 29, 2023 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients
Sutter Gould Medical Foundation PastSince Nov 29, 2023 Accepting new patients
Physiomotion Physical Therapy, Inc. Physical Therapist PastSince Aug 8, 2016 Accepting new patients

Locations

2222 Francisco Dr
Ste 120
El Dorado Hills, CA 95762
Phone (916) 235-4071

4080 N Cedar Ave
Fresno, CA 93726
Phone (559) 222-7497

631 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 368-7433

210 W Pine St
Lodi, CA 95240
Phone (209) 365-7867

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1586 Constitution Blvd
Salinas, CA 93905
Phone (831) 276-0565

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1275309205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9857 TRALEE WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956242650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-365-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARRANT",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.