Active NPI
Anthony Carratello, DPT
- Physical Therapist
- Idyllwild, CA
National Provider Identifier
1366987471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT291944
- Practice address
- 54210 Marian View Dr.
Idyllwild, CA 92549-0708 - Phone
- (951) 236-6628
- NPI assigned
- Dec 28, 2016
- Last updated
- Dec 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | PT291944 | CA | Primary |
Addresses
Primary practice location
54210 Marian View Dr.
Idyllwild, CA 92549-0708
Mailing address
PO Box 708
Idyllwild, CA 92549-0708
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 96807121G86277 | Medicaid | CA |
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 |
|---|---|---|---|
| PT291944 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1366987471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 708",
"city": "IDYLLWILD",
"state": "CA",
"postal_code": "925490708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54210 MARIAN VIEW DR.",
"city": "IDYLLWILD",
"state": "CA",
"postal_code": "925490708",
"telephone_number": "951-236-6628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRATELLO",
"first_name": "ANTHONY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-28",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT291944",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "96807121G86277",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Idyllwild, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.