Individual provider Active NPI

Derek Vandersloot, PT

  • Orthopedic Physical Therapist
  • Danville, CA
National Provider Identifier
1699835801
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
23733 Issued in CA
Practice address
380 Diablo Rd Ste 201
Danville, CA 94526-3410
Phone
(925) 552-5787
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 23733 CA Primary

Addresses

Primary practice location

380 Diablo Rd Ste 201
Danville, CA 94526-3410

Mailing address

380 Diablo Rd Ste 201
Danville, CA 94526-3410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920000341 CA Practitioner - Physical Therapist in Private Practice 9638147754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Ramon Valley Physical Therapy IncGroup PAC ID 6901874023, 12 clinicians

Practice addresses (Care Compare)

12677 Alcosta Blvd
Suite 150
San Ramon, CA 94583-4423
Phone (925) 355-1900

917 San Ramon Valley Blvd
Suite 190
Danville, CA 94526-4032
Phone (925) 552-5787

Merit-based Incentive Payment System (MIPS)

Final score
23.86 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
79.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23733CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
San Ramon Valley Physical Therapy Inc. Orthopedic CurrentSince Aug 4, 1997 Accepting new patients

Locations

917 San Ramon Valley Blvd
Ste 190
Danville, CA 94526
Phone (925) 552-5787

380 Diablo Rd
Ste 201
Danville, CA 94526
Phone (925) 552-5787

12677 Alcosta Blvd
Ste 150
San Ramon, CA 94583
Phone (925) 355-1900

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1699835801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 DIABLO RD STE 201",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945263410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 DIABLO RD STE 201",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945263410",
            "telephone_number": "925-552-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERSLOOT",
        "first_name": "DEREK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "23733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.