NPIMap

Organization Active NPI

Custom Physical Therapy Limited Partnership

  • Physical Therapy Clinic/Center
  • Sparks, NV
National Provider Identifier
1649285313
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CUSTOM PHYSICAL THERAPY LIMITED PARTNERSHIP
Practice address
1450 E Prater Way
Suite 103
Sparks, NV 89434-8972
Phone
(775) 331-1199
Fax
(775) 331-1180
NPI assigned
Jul 30, 2006
Last updated
Sep 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Authorized official

Name
Richard Binstein, JD
Title
VP/Authorized Official
Phone
(713) 297-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary
Physical Therapist 225100000X

Addresses

Primary practice location

1450 E Prater Way
Suite 103
Sparks, NV 89434-8972

Mailing address

1300 W Sam Houston Pkwy S
Suite 300
Houston, TX 77042-2447
Phone (713) 297-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030822000006 NV Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 1355252842 3 other NPIs on this enrollment
Practice locations: Reno, NV; Sparks, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649285313. Details of each certification follow.

  • CCN 296531 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 296531

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CUSTOM PHYSICAL THERAPY LP
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Oct 23, 2003
Last certification
Mar 10, 2021
Ownership / control type
Proprietary
Facility address
1450 East Prater Way Suite 103
Sparks, NV 89434

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Custom Physical Therapy Limited Partnership4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537833600000",
    "number": "1649285313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E PRATER WAY",
            "address_2": "SUITE 103",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894348972",
            "telephone_number": "775-331-1199",
            "fax_number": "775-331-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM PHYSICAL THERAPY LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-09-25",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.