Individual provider Active NPI

Travis Bartelink, DPT

  • Specialist
  • Modesto, CA
National Provider Identifier
1548409147
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35400 Issued in CA
Practice address
4028 Dale Rd
Suite 101
Modesto, CA 95356-9561
Phone
(209) 312-9739
Fax
(209) 312-9747
NPI assigned
Feb 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35400 CA Primary

Addresses

Primary practice location

4028 Dale Rd
Suite 101
Modesto, CA 95356-9561

Mailing address

4028 Dale Rd
Suite 101
Modesto, CA 95356-9561
Phone (209) 312-9739

Other identifiers 1

IdentifierTypeStateIssuer
PT35400OtherCACALIFORNIA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090527000253 CA Practitioner - Physical Therapist in Private Practice 4880743624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic Physical Therapy Institute, Inc.Group PAC ID 2264663822, 5 clinicians

Practice addresses (Care Compare)

4028 Dale Rd
Suite 101
Modesto, CA 95356-9561
Phone (209) 605-2771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35400CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Physical Therapy Institute, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Athletic & Industrial Rehabilitatn Physical Therapy Inc a Prof Corp PastSince Nov 9, 2021 Accepting new patients

Locations

3609 Oakdale Rd
Ste 3
Modesto, CA 95357
Phone (209) 312-9591

4028 Dale Rd
Ste 101
Modesto, CA 95356
Phone (209) 312-9739

Organizations & group practices 2

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": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1548409147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 DALE RD",
            "address_2": "SUITE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569561",
            "telephone_number": "209-312-9739",
            "fax_number": "209-312-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 DALE RD",
            "address_2": "SUITE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569561",
            "telephone_number": "209-312-9739",
            "fax_number": "209-312-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELINK",
        "first_name": "TRAVIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-05",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "35400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "PT35400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.