Robert Walters, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25648 Issued in CA

Practice address

1874 Tice Valley Blvd
Walnut Creek, CA 94595-2224

Phone

(925) 639-0957

NPI assigned

May 11, 2022

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tice Valley Physical Therapy and Sports Medicine IncGroup PAC ID 3476453697, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

25.65 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

85.52

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tice Valley Physical Therapy and Sports Medicine Inc.

  • Physical Therapy Clinic/Center
  • Walnut Creek, CA
  • NPI 1275633000

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Tice Valley Physcial Therapy Inc.

  • Physical Therapy Clinic/Center
  • Walnut Creek, CA
  • NPI 1578860748
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1689310799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1874 TICE VALLEY BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952224",
            "telephone_number": "925-639-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 TICE VALLEY BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945952224",
            "telephone_number": "925-639-0957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ROBERT",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W. Walsh, MD
• Jill Gregori Walson, MS CCC-SLP
• Miriam Walter, PSYD
• Diana Walters
• Ellen Walters
• Trisha Walters, PT, DPT, OCS
• Wanda Waltman, PT
• Madeleine Walton
• Matthew Walvick, D.O.
• Lawrence Wanetick, M.D. F.A.C.S.

• Physical Therapist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.