Integrated Trinity Rehabilitation PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

INTEGRATED TRINITY REHABILITATION PLLC

Practice address

901 W 24TH St
Yuma, AZ 85364-6384

Phone

(928) 726-5000

NPI assigned

Aug 5, 2020

Last updated

Aug 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fady Boutros, MDNPI 1699125880

Title

President

Phone

(909) 331-1602

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fady Boutros, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Orange, CA
  • NPI 1699125880

  AZ

  Medicare reassignment Care Compare group NPD Authorized official
• Hector Israel De la Torre, FNP-BC

  • Family Nurse Practitioner
  • San Luis, AZ
  • NPI 1205370293
  Medicare reassignment Care Compare group NPD
• Richard Allen Scott Jr., DC, NP-C

  • Family Nurse Practitioner
  • Yuma, AZ
  • NPI 1609806348
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1659981587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S 4TH AVE UNIT 5537",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853663559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646384",
            "telephone_number": "928-726-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED TRINITY REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "FADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-331-1602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Lou Inman, LASAC
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• Integrity Hearing LLC (Burgess Hearing Aids)
• Internal Medicine of Yuma LLC
• International Med Solutions Inc (International Medical Solutions Corp)
• Maria Guadalupe Inzunza
• Omar A Iqbal, MD

• Physical Medicine & Rehabilitation Physician in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.