Individual provider Active NPI

Robert James Letendre Jr., PT

  • Specialist
  • Englewood, CO
National Provider Identifier
1275617524
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6517 Issued in CO
Practice address
3601 S Pearl St
200
Englewood, CO 80113-3805
Phone
(303) 757-1554
Fax
(303) 757-3104
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 6517 CO Primary

Addresses

Primary practice location

3601 S Pearl St
200
Englewood, CO 80113-3805

Mailing address

3601 S Pearl St
200
Englewood, CO 80113-3805
Phone (303) 757-1554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060105000610 CO Practitioner - Physical Therapist in Private Practice 2062435035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy and Industrial Services PCGroup PAC ID 3779474838, 6 clinicians

Practice addresses (Care Compare)

3601 S Pearl St
Englewood, CO 80113-3894
Phone (303) 757-1554

3601 S Pearl St Unit
Suite 200
Englewood, CO 80113-3894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6517COMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy & Industrial Services PC Specialist CurrentSince Aug 4, 2010 Accepting new patients

Locations

3601 S Pearl St
Unit 200
Englewood, CO 80113
Phone (303) 757-1554

9785 Maroon Cir
Ste 157
Englewood, CO 80112

Organizations & group practices 1

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1275617524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S PEARL ST",
            "address_2": "200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133805",
            "telephone_number": "303-757-1554",
            "fax_number": "303-757-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S PEARL ST",
            "address_2": "200",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801133805",
            "telephone_number": "303-757-1554",
            "fax_number": "303-757-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETENDRE",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "6517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2010; 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.