Individual provider Active NPI

Robert John Garrett

  • Specialist
  • Thousand Oaks, CA
National Provider Identifier
1669566790
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT25829 Issued in CA
Practice address
3379 Montagne Way
Thousand Oaks, CA 91362-4836
Phone
(805) 492-4674
Fax
(805) 492-1685
NPI assigned
Oct 3, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT25829 CA Primary

Addresses

Primary practice location

3379 Montagne Way
Thousand Oaks, CA 91362-4836

Mailing address

3379 Montagne Way
Thousand Oaks, CA 91362-4836
Phone (805) 492-4674

Other identifiers 1

IdentifierTypeStateIssuer
PT25829OtherCAMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000369 CA Practitioner - Physical Therapist in Private Practice 8729001300 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Thousand Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garrett Physical Therapy Services, Inc.Group PAC ID 1052691383, 2 clinicians

Practice addresses (Care Compare)

550 Rushing Creek PL
Thousand Oaks, CA 91360-2664
Phone (805) 501-4709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT25829CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Garrett Physical Therapy Services, Inc. CurrentSince Aug 15, 2016 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

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.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1669566790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 MONTAGNE WAY",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913624836",
            "telephone_number": "805-492-4674",
            "fax_number": "805-492-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3379 MONTAGNE WAY",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913624836",
            "telephone_number": "805-492-4674",
            "fax_number": "805-492-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT25829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "PT25829",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.