Individual provider Active NPI

Daniel L Lara, PT, DPT

  • Physical Therapist
  • Galt, CA
National Provider Identifier
1568775849
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36374 Issued in CA
Practice address
1067 C St
Suite 110
Galt, CA 95632-1757
Phone
(209) 745-5802
Fax
(209) 745-5574
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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 36374 CA Primary

Addresses

Primary practice location

1067 C St
Suite 110
Galt, CA 95632-1757

Mailing address

1106 Walnut St
Suite 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101222000572 CA Practitioner - Physical Therapist in Private Practice 5395933014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic and Neurological Rehab IncGroup PAC ID 6507159126, 368 clinicians

Practice addresses (Care Compare)

8871 E Stockton Blvd
Elk Grove, CA 95624-9586
Phone (512) 327-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36374CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Aug 1, 2020 Accepting new patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Aug 1, 2020 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 571-2603

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1568775849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST",
            "address_2": "SUITE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 C ST",
            "address_2": "SUITE 110",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956321757",
            "telephone_number": "209-745-5802",
            "fax_number": "209-745-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galt, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.