Individual provider Active NPI

Apollo Robles Jr., DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1295123321
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294159 Issued in CA
Practice address
358 S Gramercy PL Apt 304
Los Angeles, CA 90020-4548
Phone
(213) 268-8785
NPI assigned
Dec 23, 2014
Last updated
Jan 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294159 CA Primary
Physical Therapy Assistant 225200000X 9025 CA

Addresses

Primary practice location

358 S Gramercy PL Apt 304
Los Angeles, CA 90020-4548

Mailing address

358 S Gramercy PL Apt 304
Los Angeles, CA 90020-4548

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240513002575 CA Practitioner - Physical Therapist in Private Practice 6305177247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interface Rehab, Inc.Group PAC ID 6204736556, 10 clinicians

Practice addresses (Care Compare)

774 S Placentia Ave
Placentia, CA 92870-6838
Phone (714) 646-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9025CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interface Rehab, Inc. CurrentSince Mar 12, 2024 Accepting new patients
Interface Rehab, Inc. CurrentSince Mar 10, 2024 Accepting new patients

Locations

744 S Placentia Ave
Ste 200
Placentia, CA 92870
Phone (714) 646-8300

774 S Placentia Ave
Ste 200
Placentia, CA 92870
Phone (714) 646-8300

6720 Saint Estaban St
Tujunga, CA 91042
Phone (818) 353-3350

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1295123321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 S GRAMERCY PL APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 S GRAMERCY PL APT 304",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204548",
            "telephone_number": "213-268-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "APOLLO",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-23",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294159",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "9025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.