Individual provider Active NPI

Bobby Ismail, P.T.

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1295880656
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20138 Issued in CA
Practice address
4318 Spyres Way
Modesto, CA 95356-9259
Phone
(209) 576-0710
Fax
(209) 576-7283
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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 PT20138 CA Primary

Addresses

Primary practice location

4318 Spyres Way
Modesto, CA 95356-9259

Mailing address

4318 Spyres Way
Modesto, CA 95356-9259
Phone (209) 576-0710

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
PT20138CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Country Therapies, Inc CurrentSince Jan 1, 2015 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist PastSince Nov 4, 2021 Accepting new patients
Barrows Training & Education Physical Therapy Physical Therapist PastSince Jun 8, 2021 Accepting new patients
Bodycentral Physical Therapy PC PastSince Mar 18, 2021 Accepting new patients
Marchant Physical Therapy & Wellness, Inc. Physical Therapist PastSince May 13, 2022 Accepting new patients
Sports Conditioning and Rehabilitation of California Inc Physical Therapist PastSince Nov 7, 2022 Accepting new patients
El Dorado Physical Therapy, Inc Physical Therapist PastSince Apr 8, 2021 Accepting new patients
Two Trees Physical Therapy & Wellness Inc Physical Therapist PastSince Dec 14, 2021 Accepting new patients
Body in Balance Physical Therapy, Inc. Physical Therapist PastSince Feb 28, 1990 Accepting new patients
Smith Therapy Partners Physical Therapist PastSince Dec 24, 2021 Accepting new patients
Physiomotion Physical Therapy, Inc. Physical Therapist PastSince Aug 8, 2016 Accepting new patients

Locations

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

Organizations & group practices 11

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1295880656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-576-0710",
            "fax_number": "209-576-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569259",
            "telephone_number": "209-576-0710",
            "fax_number": "209-576-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "BOBBY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT20138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.