Individual provider Active NPI

Robert Leslie Baker, P.T.

  • Physical Therapist
  • Pleasanton, CA
National Provider Identifier
1396779443
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13568 Issued in CA
Practice address
239 Main St Ste B
Pleasanton, CA 94566-8220
Phone
(415) 847-7147
NPI assigned
Jul 11, 2006
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 PT13568 CA Primary

Addresses

Primary practice location

239 Main St Ste B
Pleasanton, CA 94566-8220

Mailing address

1137 Essex St
Livermore, CA 94550-5538
Phone (415) 847-7147

Other identifiers 1

IdentifierTypeStateIssuer
043667600OtherCACORPORATE TAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000550 CA Practitioner - Physical Therapist in Private Practice 0446406433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

239 Main St
Suite B
Pleasanton, CA 94566-8220
Phone (925) 399-6642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13568CAMDAcupuncturist
PT13568CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stac Physical Therapy Emeryville, Inc. CurrentSince Sep 1, 2018 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 2, 2021 Accepting new patients

Locations

2322 Powell St
Emeryville, CA 94608
Phone (510) 653-5151

2322 Powell St
Ph
Emeryville, CA 94608
Phone (510) 653-5151

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1396779443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 ESSEX ST",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945505538",
            "telephone_number": "415-847-7147",
            "fax_number": "925-399-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 MAIN ST STE B",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945668220",
            "telephone_number": "415-847-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ROBERT",
        "middle_name": "LESLIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE TAX ID",
            "identifier": "043667600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.