Individual provider Active NPI

Prisco Sawal Sinfuego Jr.

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1467122960
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2119 E Hatch Rd Ste a
Modesto, CA 95351-4814
Phone
(209) 812-3055
NPI assigned
Sep 15, 2021
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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 Primary

Addresses

Primary practice location

2119 E Hatch Rd Ste a
Modesto, CA 95351-4814

Mailing address

4848 N Nottingham Ave
Chicago, IL 60656-3825
Phone (773) 541-0321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211007002757 CA Practitioner - Physical Therapist in Private Practice 7315345162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26672 Portola Pkwy
Suite 116
Foothill Ranch, CA 92610-1773
Phone (714) 450-4999

32302 Camino Capistrano
Suite 106
San Juan Capistrano, CA 92675-4505
Phone (949) 276-8845

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist Current Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Sep 1, 2024 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Oct 4, 2021 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients
Body in Balance Physical Therapy, Inc. Physical Therapist PastSince Feb 28, 1990 Accepting new patients

Locations

222 Acacia St
Fairfield, CA 94533
Phone (707) 421-0418

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

2119 E Hatch Rd
Ste A
Modesto, CA 95351
Phone (209) 803-9163

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1467122960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 N NOTTINGHAM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606563825",
            "telephone_number": "773-541-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 E HATCH RD STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514814",
            "telephone_number": "209-812-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINFUEGO",
        "first_name": "PRISCO",
        "middle_name": "SAWAL",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.