Individual provider Active NPI

Jordan Craig Ribota, PT, DPT

  • Physical Therapist
  • Buckeye, AZ
National Provider Identifier
1629623657
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30810 Issued in AZ
Practice address
825 S Watson Rd Ste 106
Buckeye, AZ 85326-3435
Phone
(623) 207-4015
Fax
(623) 471-8746
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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 30810 AZ Primary

Addresses

Primary practice location

825 S Watson Rd Ste 106
Buckeye, AZ 85326-3435

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

23374 W Yuma Rd
Buckeye, AZ 85326-3118
Phone (623) 242-6908

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191223002345 AZ Practitioner - Physical Therapist in Private Practice 1951735026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

825 S Watson Rd
Suite 106
Buckeye, AZ 85326-3435
Phone (480) 296-2987

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30810AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Orthopedic Physical Therapy, PLLC CurrentSince Oct 5, 2019 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Oct 21, 2024 Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

21250 W Roosevelt St
Ste 209
Buckeye, AZ 85326
Phone (480) 504-1532

23350 W Yuma Rd
Buckeye, AZ 85326
Phone (623) 547-5260

23478 N Sundance Pkwy
Ste 104
Buckeye, AZ 85326
Phone (623) 257-9462

825 S Watson Rd
Ste 106
Buckeye, AZ 85326
Phone (623) 207-4015

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

9980 W Glendale Ave
Ste 110
Glendale, AZ 85307
Phone (623) 226-8804

14535 W Indian School Rd
Ste 100
Goodyear, AZ 85395
Phone (623) 734-5544

14557 W Indian School Rd
Ste 500
Goodyear, AZ 85395
Phone (623) 229-7808

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

2302 N 15th Ave
Phoenix, AZ 85007
Phone (602) 265-4124

16811 N Litchfield Rd
Ste 101
Surprise, AZ 85374
Phone (602) 313-4045

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1629623657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S WATSON RD STE 106",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263435",
            "telephone_number": "623-207-4015",
            "fax_number": "623-471-8746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23374 W Yuma Rd",
            "address_purpose": "LOCATION",
            "city": "Buckeye",
            "state": "AZ",
            "postal_code": "853263118",
            "country_code": "US",
            "telephone_number": "623-242-6908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIBOTA",
        "first_name": "JORDAN",
        "middle_name": "CRAIG",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.