NPIMap

Organization Active NPI

Rascal Creek Physical Therapy a Professional Corporation.

  • Physical Therapy Clinic/Center
  • Merced, CA
National Provider Identifier
1376575837
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RASCAL CREEK PHYSICAL THERAPY A PROFESSIONAL CORPORATION.
Practice address
3327 M St
Suite a
Merced, CA 95348-2705
Phone
(209) 722-1030
Fax
(209) 722-5408
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Authorized official

Name
Antonio Hernandez, PTNPI 1396760369
Title
President
Phone
(209) 722-1030

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3327 M St
Suite a
Merced, CA 95348-2705

Mailing address

3327 M St
Suite a
Merced, CA 95348-2714
Phone (209) 722-1030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000847 CA Part B Supplier - Clinic/Group Practice 4981643632 Receives reassigned benefits from 5 practitioners
Practice locations: Merced, CA

National Provider Directory

National Provider Directory

Locations

3327 M St
Merced, CA 95348
Phone (209) 722-1030

3327 M St
Ste A
Merced, CA 95348
Phone (209) 626-9039

Practitioners & affiliated clinicians

Practitioners 11

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1376575837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 M ST",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482714",
            "telephone_number": "209-722-1030",
            "fax_number": "209-722-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 M ST",
            "address_2": "SUITE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482705",
            "telephone_number": "209-722-1030",
            "fax_number": "209-722-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RASCAL CREEK PHYSICAL THERAPY A PROFESSIONAL CORPORATION.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-722-1030",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.