Individual provider Active NPI

John-Peter Zenthoefer

  • Physical Medicine & Rehabilitation Physician
  • Riverside, CA
National Provider Identifier
1619387453
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT 40783 Issued in CA
Practice address
6177 River Crest Dr
#A
Riverside, CA 92507-0728
Phone
(951) 653-4480
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT 40783 CA Primary
Physical Therapist 225100000X PTL.0014183 CO

Addresses

Primary practice location

6177 River Crest Dr
#A
Riverside, CA 92507-0728

Mailing address

6177 River Crest Dr
#A
Riverside, CA 92507-0728
Phone (951) 653-4480

Other identifiers 1

IdentifierTypeStateIssuer
PT 40783OtherCAPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 40783CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Spine Restoration Center, Inc Physical Therapist PastSince Mar 1, 2003 Accepting new patients

Organizations & group practices 1

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": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1619387453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR",
            "address_2": "#A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR",
            "address_2": "#A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENTHOEFER",
        "first_name": "JOHN-PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-01",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT 40783",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0014183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT 40783",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.