Individual provider Active NPI

Ryan Schrader, PT, DPT

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1417571696
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298339 Issued in CA
Practice address
2301 S Melrose Dr
Vista, CA 92081-8788
Phone
(844) 316-7979
Fax
(866) 813-1235
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 298339 CA Primary

Addresses

Primary practice location

2301 S Melrose Dr
Vista, CA 92081-8788

Mailing address

7525 Metropolitan Dr Ste 306
San Diego, CA 92108-4404
Phone (619) 432-4634

Other practice location 1

7525 Metropolitan Dr Ste 306
San Diego, CA 92108-4404
Phone (619) 432-4634

Other practice location 2

1600 S Escondido Blvd
Escondido, CA 92025-6019
Phone (844) 316-7979

Other identifiers 1

IdentifierTypeStateIssuer
298339OtherCACOMMERCIAL, PPO, PRIVATE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL EMAIL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
298339CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jul 28, 2023 Accepting new patients
Livara Health Medical Group NJ, PC Physical Therapist Past Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist Past Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Interoperability endpoints

  • Direct secure messaging: rschrader388238@scrippshlth.medalliesdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1417571696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084404",
            "telephone_number": "619-432-4634",
            "fax_number": "866-813-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S MELROSE DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920818788",
            "telephone_number": "844-316-7979",
            "fax_number": "866-813-1235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 Metropolitan Dr Ste 306",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921084404",
            "country_code": "US",
            "telephone_number": "619-432-4634",
            "fax_number": "866-813-1235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 S Escondido Blvd",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920256019",
            "country_code": "US",
            "telephone_number": "844-316-7979",
            "fax_number": "866-813-1235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL, PPO, PRIVATE",
            "identifier": "298339",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EMAIL",
            "affiliation": "N",
            "address_1": "1600 S Escondido Blvd",
            "city": "Escondido",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920256019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.