Organization Active NPI

Iniguez Physical Therapy

  • Physical Therapist
  • Silver City, NM
National Provider Identifier
1689635625
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1919 Issued in NM
Legal business name
INIGUEZ PHYSICAL THERAPY
Practice address
1310 N Pope St
Silver City, NM 88061
Phone
(505) 388-0430
Fax
(505) 388-0460
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Authorized official

Name
Pedro Iniguez, MSPTNPI 1255392940
Title
Owner
Phone
(575) 388-0430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1919 NM Primary

Addresses

Primary practice location

1310 N Pope St
Silver City, NM 88061

Mailing address

1310 N Pope St
Silver City, NM 88061
Phone (505) 388-0430

Other identifiers 2

IdentifierTypeStateIssuer
53106750MedicaidNM
0000L2945MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200224000168 NM Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7810324324 Receives reassigned benefits from 2 practitioners
Practice locations: Silver City, NM; Bayard, NM

National Provider Directory

National Provider Directory

Locations

609 Central Ave
Bayard, NM 88023
Phone (505) 537-1000

1310 N Pope St
Silver City, NM 88061
Phone (505) 388-0430

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1689635625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 N POPE ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "88061",
            "telephone_number": "505-388-0430",
            "fax_number": "505-388-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N POPE ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "88061",
            "telephone_number": "505-388-0430",
            "fax_number": "505-388-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INIGUEZ PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "INIGUEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-388-0430",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53106750",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000L2945",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.