NPIMap

Organization Active NPI

Paso Robles Physical Therapy Inc

  • Physical Therapist
  • Atascadero, CA
National Provider Identifier
1609414416
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PASO ROBLES PHYSICAL THERAPY INC
Practice address
5255 El Camino Real Ste C
Atascadero, CA 93422-3351
Phone
(805) 237-0272
Fax
(805) 237-2416
NPI assigned
Dec 12, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Anthony Wallace, PTNPI 1891793923
Title
President
Phone
(805) 237-0272

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 Therapist 225100000X Primary

Addresses

Primary practice location

5255 El Camino Real Ste C
Atascadero, CA 93422-3351

Mailing address

5255 El Camino Real Ste C
Atascadero, CA 93422-3351
Phone (805) 237-0272

Other practice location 1

2150 Heritage Loop Rd Ste D
Paso Robles, CA 93446-7802
Phone (805) 237-0272

Other practice location 2

2975 Union Rd
Paso Robles, CA 93446-9320
Phone (805) 237-0272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200326002737 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315376357 Receives reassigned benefits from 11 practitioners
Practice locations: Atascadero, CA; Paso Robles, CA

National Provider Directory

National Provider Directory

Locations

5255 El Camino Real
Ste C
Atascadero, CA 93422
Phone (805) 237-0272

2150 Heritage Loop Rd
Ste D
Paso Robles, CA 93446
Phone (805) 237-0272

534 28th St
Paso Robles, CA 93446
Phone (805) 237-0272

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1609414416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 EL CAMINO REAL STE C",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223351",
            "telephone_number": "805-237-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 EL CAMINO REAL STE C",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223351",
            "telephone_number": "805-237-0272",
            "fax_number": "805-237-2416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Heritage Loop Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Paso Robles",
            "state": "CA",
            "postal_code": "934467802",
            "country_code": "US",
            "telephone_number": "805-237-0272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2975 Union Rd",
            "address_purpose": "LOCATION",
            "city": "Paso Robles",
            "state": "CA",
            "postal_code": "934469320",
            "country_code": "US",
            "telephone_number": "805-237-0272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PASO ROBLES PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-237-0272",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atascadero, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.