Lisa Riedle, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT17939 Issued in CA

Practice address

3351 El Camino Real
Suite 180
Atherton, CA 94027-3811

Phone

(650) 365-8350

Fax

(650) 365-8353

NPI assigned

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barman and Sargent IncGroup PAC ID 2163317025, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barman & Sargent Inc

  dba Diablo West Sports Medicine

  • Sports Physical Therapist
  • Menlo Park, CA
  • NPI 1225156524
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619095007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL",
            "address_2": "SUITE 180",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "940273811",
            "telephone_number": "650-365-8350",
            "fax_number": "650-365-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EL CAMINO REAL",
            "address_2": "SUITE 180",
            "city": "ATHERTON",
            "state": "CA",
            "postal_code": "940273811",
            "telephone_number": "650-365-8350",
            "fax_number": "650-365-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDLE",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT17939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT17939",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew B Newman, M.D.
• Katherine Wattiker Olivetti, LCSW
• Michelle Claudette Olsen, D.D.S.
• Pacific Endoscopy LLC (Atherton Endoscopy Center)
• Pacific Endoscopy Services (Atherton Endoscopy Center)
• Maria Esther Rivera, MD
• Cyrus S. Safai, M.D,
• Mahnoosh Sharifi, M.D.
• Shih & Olsen GP (Peninsula Endodontics Dental Group)
• Eric David Smith, M.D.

• Sports Physical Therapist in Atherton, CA
• Providers in Atherton, CA by specialty
• Sports Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.