Individual provider Active NPI

Muamar Pinagayao, PT

  • Physical Therapist
  • Cathedral City, CA
National Provider Identifier
1710567904
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28412 Issued in CA
Practice address
69472 Serenity Rd
Cathedral City, CA 92234-7921
Phone
(760) 409-6383
Fax
(866) 225-9947
NPI assigned
Apr 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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 28412 CA Primary

Addresses

Primary practice location

69472 Serenity Rd
Cathedral City, CA 92234-7921

Mailing address

69535 Jardin CT
Rancho Mirage, CA 92270-1216
Phone (760) 408-7474

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
28412CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1710567904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69535 JARDIN CT",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701216",
            "telephone_number": "760-408-7474",
            "fax_number": "866-225-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69472 SERENITY RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347921",
            "telephone_number": "760-409-6383",
            "fax_number": "866-225-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINAGAYAO",
        "first_name": "MUAMAR",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.