Individual provider Active NPI

Nathaniel James Juillerat, DPT

  • Physical Therapist
  • Buckeye, AZ
National Provider Identifier
1679264147
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-32964 Issued in AZ
Practice address
1300 S Watson Rd Ste A104
Buckeye, AZ 85326-6303
Phone
(480) 940-8299
NPI assigned
May 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 306122 CA
Physical Therapist 225100000X LPT-32964 AZ Primary

Addresses

Primary practice location

1300 S Watson Rd Ste A104
Buckeye, AZ 85326-6303

Mailing address

4314 N Greenbrier Rd
Long Beach, CA 90808-1417
Phone (623) 824-6755

Other practice location 1

5539B E Stearns St
Long Beach, CA 90815-3125
Phone (562) 855-1129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231005002207 AZ Practitioner - Physical Therapist in Private Practice 6305291683 Reassigns benefits to 1 organization
I20240823000609 CA Practitioner - Physical Therapist in Private Practice 6305291683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2888 Long Beach Blvd
Suite 405
Long Beach, CA 90806-1551
Phone (562) 595-4489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-32964AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist Current Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Aug 7, 2023 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Aug 7, 2023 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist Current Accepting new patients
California Rehab & Sports Therapy CurrentSince Aug 12, 2024 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist Past Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist Past Accepting new patients

Locations

1300 S Watson Rd
Ste A104
Buckeye, AZ 85326
Phone (480) 940-8299

1300 S Watson Rd
Ste 104
Buckeye, AZ 85326
Phone (623) 251-3201

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

415 Carmen Dr
Camarillo, CA 93010
Phone (805) 322-9083

255 E Rincon St
Ste 112
Corona, CA 92879
Phone (951) 523-8509

4755 Katella Ave
Ste 101
Cypress, CA 90720
Phone (657) 213-8687

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

5539 E Stearns St
#B
Long Beach, CA 90815
Phone (562) 855-1129

5810 Downey Ave
Long Beach, CA 90805
Phone (562) 380-2178

12539 Imperial Hwy
Ste 201
Norwalk, CA 90650
Phone (562) 379-9541

19000 Hawthorne Blvd
Ste 300
Torrance, CA 90503
Phone (310) 793-1800

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 8

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": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1679264147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 N GREENBRIER RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081417",
            "telephone_number": "623-824-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S WATSON RD STE A104",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853266303",
            "telephone_number": "480-940-8299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5539B E Stearns St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908153125",
            "country_code": "US",
            "telephone_number": "562-855-1129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUILLERAT",
        "first_name": "NATHANIEL",
        "middle_name": "JAMES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-16",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306122",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.