Individual provider Active NPI

Richard Muniz

  • Physical Therapist
  • Rancho Palos Verdes, CA
National Provider Identifier
1356021406
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT304315 Issued in CA
Practice address
28924 S Western Ave Ste 101
Rancho Palos Verdes, CA 90275-0813
Phone
(310) 548-0104
NPI assigned
Jul 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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 PT304315 CA Primary

Addresses

Primary practice location

28924 S Western Ave Ste 101
Rancho Palos Verdes, CA 90275-0813

Mailing address

939 S Cabrillo Ave Apt 8
San Pedro, CA 90731-3621
Phone (818) 606-3489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906001316 CA Practitioner - Physical Therapist in Private Practice 2769845940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28924 S Wester Ave
Suite 101
Rancho Palos Verdes, CA 90275-0813
Phone (310) 548-0104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT304315CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Aug 7, 2023 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Aug 7, 2023 Accepting new patients

Locations

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

28924 S Western Ave
Ste 101
Rch Palos Vrd, CA 90275
Phone (310) 548-0101

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1356021406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 S CABRILLO AVE APT 8",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313621",
            "telephone_number": "818-606-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28924 S WESTERN AVE STE 101",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750813",
            "telephone_number": "310-548-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNIZ",
        "first_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.