Active NPI
Robert Hartnett III, PT, DPT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1396392536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT297176
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT297176 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physiotherapy Staffing, Inc | Physical Therapist | Past | 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.
-
- Home Health Agency
- San Diego, CA
- NPI 1578795688
Physical Therapist
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.