Individual provider Active NPI

Ryan Vaughn Troll, DPT

  • Physical Therapist
  • Shasta Lake, CA
National Provider Identifier
1477008035
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT291824 Issued in CA
Practice address
5061 Shasta Dam Blvd
Shasta Lake, CA 96019-9405
Phone
(530) 275-0777
NPI assigned
Aug 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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 PT291824 CA Primary

Addresses

Primary practice location

5061 Shasta Dam Blvd
Shasta Lake, CA 96019-9405

Mailing address

PO Box 493396
Redding, CA 96049-3396
Phone (530) 221-9952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161107000311 CA Practitioner - Physical Therapist in Private Practice 6901184365 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.67 of 100Reported as group
Quality
26.11
Improvement activities
40
Cost
61.91

Merit-based Incentive Payment System (MIPS)

Final score
76.21 of 100Reported as group
Quality
38.71
Promoting interoperability
100
Improvement activities
40
Cost
68.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT291824CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baas & Wood Physical Therapy Services, Inc Physical Therapist CurrentSince May 9, 2024 Accepting new patients
Shasta Lake Physical Therapy Physical Therapist CurrentSince Aug 8, 2016 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients
Western Physical Therapy Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients

Locations

844 Bridge St
Ste C
Colusa, CA 95932
Phone (530) 458-7770

1516 State Highway 99
Ste G
Gridley, CA 95948
Phone (530) 846-8018

22038 Old 44 Dr
Palo Cedro, CA 96073
Phone (530) 221-9952

1495 Victor Ave
Ste D
Redding, CA 96003
Phone (530) 221-8090

5061 Shasta Dam Blvd
Shasta Lake, CA 96019
Phone (530) 275-0777

Organizations & group practices 5

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": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1477008035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493396",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960493396",
            "telephone_number": "530-221-9952",
            "fax_number": "530-221-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5061 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199405",
            "telephone_number": "530-275-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROLL",
        "first_name": "RYAN",
        "middle_name": "VAUGHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT291824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shasta Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.