Individual provider Active NPI

Gabriel Milo Perpetua Jr., D.P.T.

  • Physical Therapist
  • Escondido, CA
National Provider Identifier
1659722320
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34996 Issued in CA
Practice address
215 S Hickory St
Suite 112
Escondido, CA 92025-4359
Phone
(760) 737-8460
Fax
(760) 739-5669
NPI assigned
Jun 23, 2016
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34996 CA Primary

Addresses

Primary practice location

215 S Hickory St
Suite 112
Escondido, CA 92025-4359

Mailing address

29645 Rancho California Rd
Ste. 234
Temecula, CA 92591-6200
Phone (951) 506-3001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817000134 CA Practitioner - Physical Therapist in Private Practice 1254591407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

29645 Rancho California Rd
Suite 234
Temecula, CA 92591-5211
Phone (951) 506-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34996CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
All Star Physical Therapy Physical Therapist CurrentSince Jul 11, 2016 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

215 S Hickory St
Ste 112
Escondido, CA 92025
Phone (760) 737-8460

577 E Elder St
Ste I
Fallbrook, CA 92028
Phone (760) 723-2687

29798 Haun Rd
Ste 201
Menifee, CA 92586
Phone (951) 679-8500

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Top Care Home Health ServicesSan Diego, CA, CCN 557712 Home health agency Corporate Director Jun 12, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1659722320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29645 RANCHO CALIFORNIA RD",
            "address_2": "STE. 234",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916200",
            "telephone_number": "951-506-3001",
            "fax_number": "951-506-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST",
            "address_2": "SUITE 112",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254359",
            "telephone_number": "760-737-8460",
            "fax_number": "760-739-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERPETUA",
        "first_name": "GABRIEL",
        "middle_name": "MILO",
        "name_suffix": "Jr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-23",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.