Active NPI
Fernando G Dimacali, P.T.
- Physical Therapist
- Yakima, WA
National Provider Identifier
1467616953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT00010787
- Practice address
- 702 N 16TH Ave
Yakima, WA 98902-1803 - Phone
- (509) 853-2510
- Fax
- (509) 577-7193
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00010787 | WA | Primary |
Addresses
Primary practice location
702 N 16TH Ave
Yakima, WA 98902-1803
Mailing address
702 N 16TH Ave
Yakima, WA 98902-1803
Phone (509) 853-2510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0236734 | Other | WA | DEPARTMENT OF LABOR AND INDUSTRIES |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00010787 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1467616953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 N 16TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989021803",
"telephone_number": "509-853-2510",
"fax_number": "509-577-7193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 N 16TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989021803",
"telephone_number": "509-853-2510",
"fax_number": "509-577-7193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMACALI",
"first_name": "FERNANDO",
"middle_name": "G",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00010787",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LABOR AND INDUSTRIES",
"identifier": "0236734",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.