NPIMap

Organization Active NPI

Power Center Physical Therapy Incorporated

  • Physical Therapist
  • Victorville, CA
National Provider Identifier
1508948837
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
POWER CENTER PHYSICAL THERAPY INCORPORATED
Practice address
17270 Bear Valley Rd
Ste 105
Victorville, CA 92395-7751
Phone
(760) 245-8828
Fax
(855) 891-9996
NPI assigned
Oct 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Yvette B Sardillo, PTNPI 1174605406
Title
President
Phone
(760) 245-8828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

17270 Bear Valley Rd
Ste 105
Victorville, CA 92395-7751

Mailing address

17270 Bear Valley Rd
Ste 105
Victorville, CA 92395-7751
Phone (760) 245-8828

Other identifiers 2

IdentifierTypeStateIssuer
5557690001OtherCADMERC
DE2261OtherCARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050513000532 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7214978865 Receives reassigned benefits from 12 practitioners
Practice locations: Apple Valley, CA; Hesperia, CA; Victorville, CA; Yucaipa, CA

National Provider Directory

National Provider Directory

Locations

18145 US Highway 18
Ste Bf
Apple Valley, CA 92307
Phone (760) 245-8828

15972 Tuscola Rd
Ste 102
Apple Valley, CA 92307
Phone (760) 242-3353

12021 Jacaranda Ave
Ste 200
Hesperia, CA 92345
Phone (760) 244-1933

15555 Main St
Ste A15
Hesperia, CA 92345
Phone (760) 245-8828

7300 Magnolia Ave
Ste 105
Riverside, CA 92504

17270 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-8828

17270 Bear Valley Rd
Victorville, CA 92395
Phone (909) 375-1836

17260 Bear Valley Rd
Ste 105
Victorville, CA 92395
Phone (760) 245-8828

34247 Yucaipa Blvd
Ste E
Yucaipa, CA 92399
Phone (909) 233-3220

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1508948837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17270 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957751",
            "telephone_number": "760-245-8828",
            "fax_number": "855-891-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17270 BEAR VALLEY RD",
            "address_2": "STE 105",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957751",
            "telephone_number": "760-245-8828",
            "fax_number": "855-891-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER CENTER PHYSICAL THERAPY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "SARDILLO",
        "authorized_official_first_name": "YVETTE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-245-8828",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5557690001",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE2261",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.