Individual provider Active NPI

Roya Mojaverhosseini, PT

  • Physical Therapist
  • Folsom, CA
National Provider Identifier
1326646274
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18259 Issued in CA
Practice address
1301 E Bidwell St Ste 201
Folsom, CA 95630-3565
Phone
(916) 983-5915
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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 18259 CA Primary

Addresses

Primary practice location

1301 E Bidwell St Ste 201
Folsom, CA 95630-3565

Mailing address

1301 E Bidwell St Ste 201
Folsom, CA 95630-3565

Other identifiers 1

IdentifierTypeStateIssuer
18259OtherCAPT LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address providercontact@burgerrehab.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707002979 CA Practitioner - Physical Therapist in Private Practice 9638559685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1340 Lake Blvd
Davis, CA 95616-5673
Phone (530) 753-5338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jun 1, 2022 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

1340 Lake Blvd
Davis, CA 95616
Phone (530) 753-4609

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

1201 Alhambra Blvd
Ste 200
Sacramento, CA 95816
Phone (916) 731-7900

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

475 Pioneer Ave
Ste 200
Woodland, CA 95776
Phone (530) 406-5620

Organizations & group practices 4

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": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1326646274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL ST STE 201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E BIDWELL ST STE 201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303565",
            "telephone_number": "916-983-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJAVERHOSSEINI",
        "first_name": "ROYA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "18259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "18259",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "providercontact@burgerrehab.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1301 E Bidwell St Ste 201",
            "city": "Folsom",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956303565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.