Active NPI
Gabriel A Fonseca, PT
- Physical Therapist
- Yuma, AZ
National Provider Identifier
1356430755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6229
- Practice address
- 1951 W 25TH St
Ste C
Yuma, AZ 85364-6925 - Phone
- (928) 726-7900
- Fax
- (928) 726-7901
- NPI assigned
- Oct 12, 2006
- Last updated
- Oct 22, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6229 | AZ | Primary |
Addresses
Primary practice location
1951 W 25TH St
Ste C
Yuma, AZ 85364-6925
Mailing address
PO Box 6956
Yuma, AZ 85366-2546
Phone (928) 726-7900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6229 | AZ | MD | Facial Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Assisted Living Concepts Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Copper Hills House
- Assisted Living Facility
- Yuma, AZ
- NPI 1922124494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1356430755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6956",
"city": "YUMA",
"state": "AZ",
"postal_code": "853662546",
"telephone_number": "928-726-7900",
"fax_number": "928-726-7901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 W 25TH ST",
"address_2": "STE C",
"city": "YUMA",
"state": "AZ",
"postal_code": "853646925",
"telephone_number": "928-726-7900",
"fax_number": "928-726-7901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONSECA",
"first_name": "GABRIEL",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "6229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.