NPIMap

Organization Active NPI

Biosport Physical Therapy Tracy Inc

  • Physical Therapy Clinic/Center
  • Tracy, CA
National Provider Identifier
1710670906
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BIOSPORT PHYSICAL THERAPY TRACY INC
Practice address
2156 W Grant Line Rd Ste 215
Tracy, CA 95377-7337
Phone
(209) 318-0282
Fax
(209) 318-0283
NPI assigned
Jun 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Dr. Karandeep Gill, DPTNPI 1598367831
Title
Owner / Physical Therapist
Phone
(209) 627-6670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2156 W Grant Line Rd Ste 215
Tracy, CA 95377-7337

Mailing address

PO Box 576751
Modesto, CA 95357-6751
Phone (209) 524-7488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230918000692 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406210996 Receives reassigned benefits from 6 practitioners
Practice locations: Tracy, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1710670906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576751",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576751",
            "telephone_number": "209-524-7488",
            "fax_number": "209-522-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 W GRANT LINE RD STE 215",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777337",
            "telephone_number": "209-318-0282",
            "fax_number": "209-318-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOSPORT PHYSICAL THERAPY TRACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KARANDEEP",
        "authorized_official_title_or_position": "OWNER / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "209-627-6670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.