Ryan Haddock, PTLA

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

144 W Los Angeles Ave
#110
Moorpark, CA 93021-1898

Phone

(805) 552-1915

Fax

(805) 552-1991

NPI assigned

Mar 13, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Xcel Physical Therapy and Wellness Center PCGroup PAC ID 9638696586, 4 clinicians

Xcelerate Physical Therapy Inc.Group PAC ID 4385621374, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Xcel Physical Therapy & Wellness Center PC

  • Physical Therapy Clinic/Center
  • Moorpark, CA
  • NPI 1932912094

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Xcelerate Physical Therapy Inc.

  • Physical Therapist
  • Thousand Oaks, CA
  • NPI 1306814124
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1376936492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 W LOS ANGELES AVE",
            "address_2": "#110",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211898",
            "telephone_number": "805-552-1915",
            "fax_number": "805-552-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 W LOS ANGELES AVE",
            "address_2": "#110",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211898",
            "telephone_number": "805-552-1915",
            "fax_number": "805-552-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PTLA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Gonzalez
• Lauren Gonzalez, WHNP-BC
• Jill Grannis, D.M.D.
• Genesis Guillen
• Amelia Faith Gutierrez
• James Handal, PTA
• Maritza Carolina Handal
• Harmony Rehabilitation Center LLC
• Shirley Il Hartman, LCSW
• Erik J Hasan, PT,DPT

• Physical Therapist in Moorpark, CA
• Providers in Moorpark, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.