Individual provider Active NPI

Ronaldo Basto Coloma, RPT

  • Physical Therapist
  • Joliet, IL
National Provider Identifier
1699900910
Registry record updated May 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.014683 Issued in IL
Practice address
2203 Pembridge LN
Joliet, IL 60431-7731
Phone
(815) 409-8301
Fax
(815) 267-8505
NPI assigned
May 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.014683 IL Primary

Addresses

Primary practice location

2203 Pembridge LN
Joliet, IL 60431-7731

Mailing address

2203 Pembridge LN
Joliet, IL 60431-7731
Phone (815) 409-8301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.014683ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Care Rehab, Inc. Physical Therapist Past Accepting new patients
VCP Home Health Care Inc PastSince May 20, 2008 Accepting new patients
Garden State Spine and Pain Institute LLC Physical Therapist PastSince Jan 2, 2023 Accepting new patients

Organizations & group practices 3

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": "1242518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242518400000",
    "number": "1699900910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2203 PEMBRIDGE LN",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604317731",
            "telephone_number": "815-409-8301",
            "fax_number": "815-267-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 PEMBRIDGE LN",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604317731",
            "telephone_number": "815-409-8301",
            "fax_number": "815-267-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMA",
        "first_name": "RONALDO",
        "middle_name": "BASTO",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-17",
        "last_updated": "2009-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.