Individual provider Active NPI

Robert Hartnett III, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1396392536
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT297176 Issued in CA
Practice address
2941 4TH Ave
San Diego, CA 92103-5901
Phone
(619) 888-5838
NPI assigned
Aug 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT297176 CA Primary

Addresses

Primary practice location

2941 4TH Ave
San Diego, CA 92103-5901

Mailing address

11818 Asti Dr
Rancho Cucamonga, CA 91701-9004

Other practice location 1

11818 Asti Dr
Rancho Cucamonga, CA 91701-9004
Phone (703) 470-7606

Other practice location 2

11818 Asti Dr
Rancho Cucamonga, CA 91701-9004
Phone (703) 470-7606

Other practice location 3

275 Garnet Way
Upland, CA 91786-5932
Phone (909) 949-4887

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT297176CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physiotherapy Staffing, Inc Physical Therapist PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1396392536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11818 ASTI DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921035901",
            "telephone_number": "619-888-5838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11818 Asti Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917019004",
            "country_code": "US",
            "telephone_number": "703-470-7606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11818 Asti Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917019004",
            "country_code": "US",
            "telephone_number": "703-470-7606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Garnet Way",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917865932",
            "country_code": "US",
            "telephone_number": "909-949-4887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTNETT",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT297176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.