Omar Bracamontes, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50828 Issued in CA

Practice address

26471 Crown Valley Pkwy
Mission Viejo, CA 92691-6378

Phone

(949) 916-2601

NPI assigned

Oct 18, 2020

Last updated

Oct 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richards Physical Therapy Inc

  dba DBA Professional Physical Therapy

  • Physical Therapist
  • Mission Viejo, CA
  • NPI 1528065588
  NPD (past)

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

{
    "created_epoch": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1669071031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26471 CROWN VALLEY PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916378",
            "telephone_number": "949-916-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26471 CROWN VALLEY PKWY",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916378",
            "telephone_number": "949-916-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACAMONTES",
        "first_name": "OMAR",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-18",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas John Bowden, DOCTORATE
• Toni Bowie
• Boyd Dental Corporation (Alicia Orthodontic & Pediatric Specialties)
• Chase Snow Boyle, MFTI
• Anel Bracamontes
• Deborah Lynn Brackett, PT
• Michael Patrick Brackett, P.T.
• Michele Bradley I, LVN
• Adriana Lanca Brady
• Emily Fish Brady, MD, MPH

• Physical Therapy Assistant in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2020; 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.