East Bay Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12835 Issued in CA

Legal business name

EAST BAY PHYSICAL THERAPY, INC.

Practice address

3571 San Pablo Dam Rd
Richmond, CA 94803-2727

Phone

(510) 222-8080

Fax

(510) 222-8083

NPI assigned

Nov 22, 2006

Last updated

Apr 17, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Michael Scerri, B.S.NPI 1861973216

Title

Director

Phone

(510) 222-8080

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

East Bay Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• East Bay Physical Therapy, Inc.

  • Physical Therapist
  • Antioch, CA
  • NPI 1750592044
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Scerri

  • Durable Medical Equipment & Medical Supplies
  • Richmond, CA
  • NPI 1861973216
  NPD Authorized official

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555459200000",
    "number": "1437224383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3571 SAN PABLO DAM RD",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948032727",
            "telephone_number": "510-222-8080",
            "fax_number": "510-222-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 SAN PABLO DAM RD",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948032727",
            "telephone_number": "510-222-8080",
            "fax_number": "510-222-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2019-04-17",
        "status": "A",
        "authorized_official_last_name": "SCERRI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "510-222-8080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "22298",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "12835",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "19723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latanya Marie Duree
• Peace Amarachi Duru
• Jonah Dvorin
• Early Childhood Mental Health Program
• Jessica Danielle Early, MSN, APRN, FNP-C
• Jeffrey A. East, MD
• Easylife DME Solution LLC
• Darla Jean Eboh, ANP
• Edgardo S Rubio DMD Corp
• Chynna Nalani Edwards

• Physical Therapist in Richmond, CA
• Providers in Richmond, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.