Individual provider Active NPI

Ronald Joseph Cervantes, PT

  • Physical Therapist
  • Azusa, CA
National Provider Identifier
1427035609
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38117 Issued in CA
Practice address
830 S Citrus Ave Ste 203
Azusa, CA 91702-5959
Phone
(626) 339-6514
Fax
(626) 339-6573
NPI assigned
Dec 28, 2005
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 38117 CA Primary

Addresses

Primary practice location

830 S Citrus Ave Ste 203
Azusa, CA 91702-5959

Mailing address

830 S Citrus Ave Ste 203
Azusa, CA 91702-5959
Phone (626) 339-6514

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130325000222 CA Practitioner - Physical Therapist in Private Practice 2466697321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38117CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Algos Inc., a Medical Corporation Physical Therapist CurrentSince Oct 25, 2019 Accepting new patients
Algos Inc., a Medical Corporation Physical Therapist Current Accepting new patients
Algos Inc., a Medical Corporation Physical Therapist CurrentSince Oct 25, 2019 Accepting new patients
Interface Rehab, Inc. PastSince Mar 12, 2024 Accepting new patients
Algos Inc., a Medical Corporation Physical Therapist Past Accepting new patients
United Therapy Network Inc Physical Therapist Past Accepting new patients

Locations

830 S Citrus Ave
Ste 203
Azusa, CA 91702
Phone (626) 339-6514

13193 Central Ave
Ste 220
Chino, CA 91710
Phone (909) 591-0843

891 Kuhn Dr
Ste 106
Chula Vista, CA 91914
Phone (619) 761-5308

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

10565 Civic Center Dr
Ste 165
Rch Cucamonga, CA 91730
Phone (888) 824-2144

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1427035609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S CITRUS AVE STE 203",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025959",
            "telephone_number": "626-339-6514",
            "fax_number": "626-339-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S CITRUS AVE STE 203",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917025959",
            "telephone_number": "626-339-6514",
            "fax_number": "626-339-6573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.