NPIMap

Organization Active NPI

Tracy L Malan RPT Apc

  • Physical Therapist
  • Barstow, CA
National Provider Identifier
1528083227
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12940 Issued in CA
Legal business name
TRACY L MALAN RPT APC
Practice address
525 Melissa Ave
Ste B
Barstow, CA 92311-3002
Phone
(760) 256-1888
Fax
(760) 256-2893
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Tracy L Malan, PTNPI 1154323020
Title
Owner / Ceo
Phone
(760) 256-1888

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 PT12940 CA Primary

Addresses

Primary practice location

525 Melissa Ave
Ste B
Barstow, CA 92311-3002

Mailing address

525 Melissa Ave
Ste B
Barstow, CA 92311-3002
Phone (760) 256-1888

Other names 1

  • Chaparral Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040612000488 CA Part B Supplier - Clinic/Group Practice 0446233092 Receives reassigned benefits from 3 practitioners
Practice locations: Barstow, CA

National Provider Directory

National Provider Directory

Locations

525 Melissa Ave
Ste B
Barstow, CA 92311
Phone (760) 256-1888

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1528083227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 MELISSA AVE",
            "address_2": "STE B",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113002",
            "telephone_number": "760-256-1888",
            "fax_number": "760-256-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 MELISSA AVE",
            "address_2": "STE B",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113002",
            "telephone_number": "760-256-1888",
            "fax_number": "760-256-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY L MALAN RPT APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MALAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "760-256-1888",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chaparral Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.