Individual provider Active NPI

Bethany Estelle Gradert, MSPT

  • Physical Therapist
  • San Francisco, CA
National Provider Identifier
1275659484
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25227 Issued in CA
Practice address
1640 Valencia St Ste 1C
San Francisco, CA 94110-5040
Phone
(415) 654-5324
Fax
(415) 654-5327
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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 25227 CA Primary

Addresses

Primary practice location

1640 Valencia St Ste 1C
San Francisco, CA 94110-5040

Mailing address

1640 Valencia St Ste 1C
San Francisco, CA 94110-5040
Phone (415) 654-5324

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
25227CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Kidz Physical Therapy Physical Therapist CurrentSince Feb 16, 2025 Accepting new patients

Locations

1640 Valencia St
Ste 1C
San Francisco, CA 94110
Phone (415) 654-5324

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1275659484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 VALENCIA ST STE 1C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941105040",
            "telephone_number": "415-654-5324",
            "fax_number": "415-654-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 VALENCIA ST STE 1C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941105040",
            "telephone_number": "415-654-5324",
            "fax_number": "415-654-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADERT",
        "first_name": "BETHANY",
        "middle_name": "ESTELLE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.