Individual provider Active NPI

Jason Thad Stracker, PT, DPT

  • Orthopedic Physical Therapist
  • Pasadena, CA
National Provider Identifier
1710072020
Registry record updated Feb 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 29614 Issued in CA
Practice address
959 E Walnut St Ste 240
Pasadena, CA 91106-1451
Phone
(626) 795-2390
Fax
(626) 795-2391
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2019

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 PT 29614 CA Primary

Addresses

Primary practice location

959 E Walnut St Ste 240
Pasadena, CA 91106-1451

Mailing address

1421 N Wanda Rd
# 120-V4
Orange, CA 92867-5343
Phone (714) 514-1799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070409000658 CA Practitioner - Physical Therapist in Private Practice 5799889366 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 29614CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stracker Physical Therapy, Inc. Orthopedic CurrentSince Jun 13, 2013 Accepting new patients
Landswick Physical Therapy, Inc. Orthopedic CurrentSince Feb 27, 2007 Accepting new patients

Locations

1421 N Wanda Rd
Ste 120
Orange, CA 92867
Phone (714) 514-5286

959 E Walnut St
Ste 240
Pasadena, CA 91106
Phone (626) 795-2390

Organizations & group practices 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550880000000",
    "number": "1710072020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 N WANDA RD",
            "address_2": "# 120-V4",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928675343",
            "telephone_number": "714-514-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 E WALNUT ST STE 240",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061451",
            "telephone_number": "626-795-2390",
            "fax_number": "626-795-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRACKER",
        "first_name": "JASON",
        "middle_name": "THAD",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 29614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; 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.