Individual provider Active NPI

Julio C Fuentes, PT, DPT

  • Orthopedic Physical Therapist
  • Twentynine Palms, CA
National Provider Identifier
1710244090
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT36676 Issued in CA
Practice address
5930 Adobe Rd
Twentynine Palms, CA 92277-2356
Phone
(760) 367-1743
Fax
(760) 367-1083
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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 PT36676 CA Primary

Addresses

Primary practice location

5930 Adobe Rd
Twentynine Palms, CA 92277-2356

Mailing address

3350 Valley Rd
Bonita, CA 91902-4171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180419000527 CA Practitioner - Physical Therapist in Private Practice 3173886439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone (858) 499-2600

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36676CAMDClinical Psychologist
PT36676CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
H.D.P.R.G., Inc PastSince Aug 1, 2015 Accepting new patients

Organizations & group practices 4

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1710244090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 VALLEY RD",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919024171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 ADOBE RD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922772356",
            "telephone_number": "760-367-1743",
            "fax_number": "760-367-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "JULIO",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT36676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.