Patrick T Black, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

42237 Issued in CA

Practice address

1676 E 6TH St
Beaumont, CA 92223-5760

Phone

(951) 769-0300

NPI assigned

Feb 16, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adorador Enterprises Inc

  • Physical Therapy Clinic/Center
  • Beaumont, CA
  • NPI 1861402950

  CA

  Medicare reassignment NPD
• Sakari Wound Specialists, a Professional Nursing Corporation

  • Family Nurse Practitioner
  • Redlands, CA
  • NPI 1962368696

  CA

  Medicare reassignment
• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD
• Neighborhood Healthcare

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD (past)

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1326439159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1676 E 6TH ST",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 E 6TH ST",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235760",
            "telephone_number": "951-769-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "PATRICK",
        "middle_name": "T",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taiye Beoghene
• Jessica Betts
• Beyond a-Z Speech Therapy Services, Inc.
• Michelle Ashley Bird
• Birthing Purpose Doula Services LLC
• Amber R Blackford, D.C.
• Gerald Theadore Blackmon III
• Nicole Nadine Blizzard, MS, OTR/L
• Amanda Bojorquez, LCSW
• Clark Anthony Botha, BPHARM, RPH

• All providers in Beaumont, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.