Organization Active NPI

Slootsky Physical Medicine & Rehabilitation, PC

  • Physical Medicine & Rehabilitation Physician
  • Modesto, CA
National Provider Identifier
1366323032
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SLOOTSKY PHYSICAL MEDICINE & REHABILITATION, PC
Practice address
1303 Mable Ave
Modesto, CA 95355-1119
Phone
(209) 857-3400
NPI assigned
Sep 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Bryan Slootsky, DONPI 1861067985
Title
Physician/Owner
Phone
(561) 702-4012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1303 Mable Ave
Modesto, CA 95355-1119

Mailing address

2365 Le Conte Ave Apt B
Berkeley, CA 94709-1360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251031002652 CA Part B Supplier - Clinic/Group Practice 1456840131 Receives reassigned benefits from 1 practitioner
Practice locations: Modesto, CA

National Provider Directory

National Provider Directory

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": "1757462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1366323032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 LE CONTE AVE APT B",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MABLE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551119",
            "telephone_number": "209-857-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLOOTSKY PHYSICAL MEDICINE & REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "SLOOTSKY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "561-702-4012",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.