Individual provider Active NPI

Rozalyn Bagasol, DPT

  • Physical Therapist
  • San Jose, CA
National Provider Identifier
1295928083
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32041 Issued in CA
Practice address
121 Bernal Rd Ste 30
San Jose, CA 95119-1396
Phone
(408) 227-2141
Fax
(408) 227-2141
NPI assigned
Aug 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 PT32041 CA Primary

Addresses

Primary practice location

121 Bernal Rd Ste 30
San Jose, CA 95119-1396

Mailing address

4205 San Felipe Rd
Ste 100
San Jose, CA 95135-1546
Phone (408) 238-1552

Other names 1

  • Rozalyn Pelayo Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110120000429 CA Practitioner - Physical Therapist in Private Practice 2668651894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Creek Fitness and Physical TherapyGroup PAC ID 7012994791, 38 clinicians

Practice addresses (Care Compare)

121 Bernal Rd
San Jose, CA 95119-1396
Phone (408) 227-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT32041CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Physical Therapy & Human Performance Center, Inc Physical Therapist PastSince Jun 11, 2002 Accepting new patients
Balance Physical Therapy & Human Performance Center, Inc PastSince Jun 6, 2021 Accepting new patients

Organizations & group practices 3

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": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1295928083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 SAN FELIPE RD",
            "address_2": "STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351546",
            "telephone_number": "408-238-1552",
            "fax_number": "408-238-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BERNAL RD STE 30",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191396",
            "telephone_number": "408-227-2141",
            "fax_number": "408-227-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGASOL",
        "first_name": "ROZALYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT32041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROZALYN",
            "last_name": "PELAYO",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.