NPIMap

Organization Active NPI

Marketplace Physical Therapy Inc, a Professional Corporation

  • Physical Therapy Clinic/Center
  • Riverside, CA
National Provider Identifier
1285190942
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MARKETPLACE PHYSICAL THERAPY INC, A PROFESSIONAL CORPORATION
Practice address
3191 Mission Inn Ave Ste B
Riverside, CA 92507-4188
Phone
(951) 376-2692
Fax
(951) 684-2980
NPI assigned
Feb 18, 2019
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Miss Gabriela Cubillas
Title
Cao
Phone
(951) 905-8014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

3191 Mission Inn Ave Ste B
Riverside, CA 92507-4188

Mailing address

3191 Mission Inn Ave Ste B
Riverside, CA 92507-4188
Phone (951) 684-2874

Other practice location 1

14682 Central Ave
Chino, CA 91710-9505
Phone (909) 217-3664

Other practice location 2

1620 E 2nd St Ste Ijk
Beaumont, CA 92223-3171
Phone (951) 370-1325

Other practice location 3

210 E Citrus Ave
Redlands, CA 92373-5215
Phone (951) 376-3380

Other practice location 4

4270 Riverwalk Pkwy Ste 112
Riverside, CA 92505-3374
Phone (951) 324-4291

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190430000889 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0244572964 Receives reassigned benefits from 18 practitioners
Practice locations: Riverside, CA; Redlands, CA; Chino, CA; Beaumont, CA

National Provider Directory

National Provider Directory

Locations

1620 E Second St
Ste Iandj
Beaumont, CA 92223
Phone (951) 370-1325

1620 E Second St
Ste Ij
Beaumont, CA 92223

1620 E Second St
Ste Ijk
Beaumont, CA 92223
Phone (951) 370-1325

210 E Citrus Ave
Redlands, CA 92373
Phone (951) 376-3380

500 Orange St
Redlands, CA 92374
Phone (951) 376-3380

4270 Riverwalk Pkwy
Riverside, CA 92505

4270 Riverwalk Pkwy
Ste 112
Riverside, CA 92505
Phone (951) 324-4291

4270 Riverwalk Pkwy
Ste 114
Riverside, CA 92505
Phone (951) 324-4291

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1285190942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 MISSION INN AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074188",
            "telephone_number": "951-684-2874",
            "fax_number": "951-684-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 MISSION INN AVE STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074188",
            "telephone_number": "951-376-2692",
            "fax_number": "951-684-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14682 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917109505",
            "country_code": "US",
            "telephone_number": "909-217-3664",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1620 E 2nd St Ste Ijk",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922233171",
            "country_code": "US",
            "telephone_number": "951-370-1325",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 E Citrus Ave",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923735215",
            "country_code": "US",
            "telephone_number": "951-376-3380",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4270 Riverwalk Pkwy Ste 112",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925053374",
            "country_code": "US",
            "telephone_number": "951-324-4291",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARKETPLACE PHYSICAL THERAPY INC, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "CUBILLAS",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "951-905-8014",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.