Organization Active NPI

J Trees Ritter D.O., Inc.

  • Infusion Therapy Clinic/Center
  • San Luis Obispo, CA
National Provider Identifier
1356802128
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
J TREES RITTER D.O., INC.
Practice address
1250 Peach St Ste M
San Luis Obispo, CA 93401-2877
Phone
(805) 540-0689
NPI assigned
Mar 26, 2019
Organization subpart
Yes
Parent organization
J TREES RITTER D.O., INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Jethro Trees Ritter, DO
Title
President
Phone
(805) 305-5296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

1250 Peach St Ste M
San Luis Obispo, CA 93401-2877

Mailing address

PO Box 1206
Goleta, CA 93116-1206
Phone (805) 964-3838

Other practice location 1

24640 Jefferson Ave Ste 208
Murrieta, CA 92562-9027
Phone (877) 448-3627

Other practice location 2

17768 Wika Rd Ste 200
Apple Valley, CA 92307-1200
Phone (877) 448-3627

Other names 1

  • MIC CA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070723000803 CA Part B Supplier - Clinic/Group Practice 3274634035 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Luis Obispo, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
J Trees Ritter DO Inc

Locations

1250 Peach St
Ste M
San Luis Obispo, CA 93401
Phone (805) 540-0689

130 La Casa Via
Walnut Creek, CA 94598

130 La Casa Via
Ste 108
Walnut Creek, CA 94598

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1356802128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1206",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931161206",
            "telephone_number": "805-964-3838",
            "fax_number": "805-638-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PEACH ST STE M",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012877",
            "telephone_number": "805-540-0689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24640 Jefferson Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925629027",
            "country_code": "US",
            "telephone_number": "877-448-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17768 Wika Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923071200",
            "country_code": "US",
            "telephone_number": "877-448-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J TREES RITTER D.O., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J TREES RITTER D.O., INC.",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "JETHRO",
        "authorized_official_middle_name": "TREES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-305-5296",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIC CA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MIC CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.