Organization Active NPI

North Bay Physical Therapy Inc

Doing business as North Bay Phys Ther

  • Physical Therapist
  • Santa Cruz, CA
National Provider Identifier
1699719047
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTH BAY PHYSICAL THERAPY INC
Doing business as
North Bay Phys Ther
Practice address
9000 Soquel Ave
Ste 101a
Santa Cruz, CA 95062
Phone
(831) 462-5777
Fax
(831) 462-5779
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Authorized official

Name
Mr. Scott G Shaffer, PTNPI 1932145372
Title
Owner President
Phone
(831) 462-5777

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 Primary

Addresses

Primary practice location

9000 Soquel Ave
Ste 101a
Santa Cruz, CA 95062

Mailing address

9000 Soquel Ave
Ste 101a
Santa Cruz, CA 95062
Phone (831) 462-5777

Other names 1

  • North Bay Phys Ther Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060123000330 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3072537653 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Cruz, CA

National Provider Directory

National Provider Directory

Locations

9000 Soquel Ave
Ste 101A
Santa Cruz, CA 95062
Phone (831) 204-5676

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1699719047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 SOQUEL AVE",
            "address_2": "STE 101A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95062",
            "telephone_number": "831-462-5777",
            "fax_number": "831-462-5779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 SOQUEL AVE",
            "address_2": "STE 101A",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95062",
            "telephone_number": "831-462-5777",
            "fax_number": "831-462-5779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BAY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "831-462-5777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Bay Phys Ther",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; 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.