Individual provider Active NPI

Larissa Nicole Romero

  • Physical Therapist
  • Madera, CA
National Provider Identifier
1518740182
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304601 Issued in CA
Practice address
309 S. Gateway Dr.
Madera, CA 93637
Phone
(559) 674-7201
NPI assigned
Aug 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 304601 CA Primary

Addresses

Primary practice location

309 S. Gateway Dr.
Madera, CA 93637

Mailing address

3513 W Mesa Ave
Fresno, CA 93711-1547
Phone (559) 577-2059

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002001318 CA Practitioner - Physical Therapist in Private Practice 0244684751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrows Training and Ed P T - Fresno a P CGroup PAC ID 8729001573, 12 clinicians

Practice addresses (Care Compare)

1752 E Bullard Ave
Suite 103
Fresno, CA 93710-5864
Phone (559) 438-0355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304601CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrows Training & Ed - P T Fresno a P C Physical Therapist CurrentSince Aug 19, 2023 Accepting new patients

Locations

1752 E Bullard Ave
Ste 103
Fresno, CA 93710
Phone (559) 438-0355

309 S Gateway Dr
Madera, CA 93637
Phone (559) 438-0355

Organizations & group practices 1

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1518740182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 W MESA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937111547",
            "telephone_number": "559-577-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S. GATEWAY DR.",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "93637",
            "telephone_number": "559-674-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "LARISSA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.