Individual provider Active NPI

Carmela Reynoso

  • Physical Therapist
  • Cathedral City, CA
National Provider Identifier
1598733164
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT32508 Issued in CA
Practice address
35325 Date Palm Dr Ste 131
Cathedral City, CA 92234-7031
Phone
(760) 202-0368
Fax
(760) 770-1973
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 PT32508 CA Primary

Addresses

Primary practice location

35325 Date Palm Dr Ste 131
Cathedral City, CA 92234-7031

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000755 CA Practitioner - Physical Therapist in Private Practice 5193733384 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT32508CAMDPhysical Therapist
32508CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mangan Physical Therapy Inc Physical Therapist CurrentSince Feb 2, 2016 Accepting new patients
GTMS Fitness Corporation Physical Therapist CurrentSince Jan 31, 2022 Accepting new patients
The Rehab Group Physical Therapist CurrentSince Sep 6, 2022 Accepting new patients

Locations

39815 Alta Murrieta Dr
Ste C1
Murrieta, CA 92563
Phone (951) 268-8865

38860 Sky Canyon Dr
Bldg A
Murrieta, CA 92563
Phone (442) 777-5920

40680 California Oaks Rd
Ste 2A
Murrieta, CA 92562
Phone (951) 894-4800

29377 Rancho California Rd
Ste 100
Temecula, CA 92591
Phone (951) 296-0400

Organizations & group practices 3

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1598733164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "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": "35325 DATE PALM DR STE 131",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347031",
            "telephone_number": "760-202-0368",
            "fax_number": "760-770-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "CARMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT32508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.