Individual provider Active NPI

Rolando Witrado III, P.T.

  • Physical Therapist
  • Sanger, CA
National Provider Identifier
1275734550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32411 Issued in CA
Practice address
2570 Jensen Ave
Suite #108
Sanger, CA 93657-2269
Phone
(559) 875-2220
Fax
(559) 875-2220
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 32411 CA Primary

Addresses

Primary practice location

2570 Jensen Ave
Suite #108
Sanger, CA 93657-2269

Mailing address

1620 S 3Rd St
Fresno, CA 93702-4150
Phone (559) 875-2220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000050 CA Practitioner - Physical Therapist in Private Practice 7416105937 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Rebound Physical Therapy IncGroup PAC ID 8325102353, 4 clinicians

Practice addresses (Care Compare)

7206 N Milburn Ave
Suite 102
Fresno, CA 93722-8450
Phone (559) 271-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32411CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Rehab Physical Therapy Inc. Physical Therapist CurrentSince Dec 13, 2017 Accepting new patients
Rebound Physical Therapy Inc. CurrentSince Apr 16, 2018 Accepting new patients
Michael Martines Physical Therapist, Physical Therapist PastSince Oct 26, 2012 Accepting new patients
Sanger Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Advanced Physical and Occupational Therapy Physical Therapist Past Accepting new patients

Locations

7355 N Palm Ave
Ste 107
Fresno, CA 93711
Phone (559) 579-1555

7405 N Cedar Ave
Ste 103
Fresno, CA 93720
Phone (559) 261-4100

7206 N Milburn Ave
Ste 102
Fresno, CA 93722
Phone (559) 271-3100

1581 18th Ave
Kingsburg, CA 93631
Phone (559) 897-5270

Organizations & group practices 5

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": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275734550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S 3RD ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937024150",
            "telephone_number": "559-875-2220",
            "fax_number": "559-875-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 JENSEN AVE",
            "address_2": "SUITE #108",
            "city": "SANGER",
            "state": "CA",
            "postal_code": "936572269",
            "telephone_number": "559-875-2220",
            "fax_number": "559-875-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITRADO",
        "first_name": "ROLANDO",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "32411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanger, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.