Individual provider Active NPI

Melissa Tenkate, PT

  • Physical Therapist
  • Arroyo Grande, CA
National Provider Identifier
1710343496
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
43406 Issued in CA
Practice address
1510 W Branch St
Arroyo Grande, CA 93420-1817
Phone
(805) 489-7912
Fax
(805) 489-9697
NPI assigned
Jan 11, 2016
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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 43406 CA Primary

Addresses

Primary practice location

1510 W Branch St
Arroyo Grande, CA 93420-1817

Mailing address

1106 Walnut St
Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805

Other identifiers 1

IdentifierTypeStateIssuer
056608OtherCAMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419002367 CA Practitioner - Physical Therapist in Private Practice 9931407251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Physical Therapy and Wellness Center, PCGroup PAC ID 1254665441, 8 clinicians

Practice addresses (Care Compare)

211 Tank Farm Rd
Suite a
San Luis Obispo, CA 93401-7509
Phone (805) 439-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43406CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Physical Therapy and Wellness Center, PC Physical Therapist CurrentSince Oct 5, 2020 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist PastSince Dec 26, 2016 Accepting new patients
Timothy H. Jones, M.D., Inc. PastSince Oct 5, 2020 Accepting new patients

Locations

211 Tank Farm Rd
Ste A
Sn Luis Obisp, CA 93401
Phone (805) 439-3900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1710343496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST",
            "address_2": "STE 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W BRANCH ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201817",
            "telephone_number": "805-489-7912",
            "fax_number": "805-489-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENKATE",
        "first_name": "MELISSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "056608",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.