Rafael David Pena, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA01130 Issued in RI

Practice address

2871 Post Rd
Prehab Sports Medicare Services Inc.
Warwick, RI 02886-0076

Phone

(401) 463-3060

Fax

(401) 732-1045

NPI assigned

Aug 2, 2017

Last updated

Aug 2, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Prehab Sports Medicine Services Inc

  • Physical Therapist
  • Warwick, RI
  • NPI 1548383631
  NPD

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501632000000",
    "number": "1720502677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2871 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028863116",
            "telephone_number": "401-463-3060",
            "fax_number": "401-732-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2871 POST RD",
            "address_2": "PREHAB SPORTS MEDICARE SERVICES INC.",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028860076",
            "telephone_number": "401-463-3060",
            "fax_number": "401-732-1045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "RAFAEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "RI",
            "license": "PTA01130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "402551",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "7542-8",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "64-00223",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace M Pelletier
• Kimberly Pelletier, LCISW
• Shaye L. Pelletier, LMHC-A
• Pelvic Health & Wellness LLC (Full Circle Pelvic Health)
• Ruby Pena Puello, FNP-C
• Pendar Investments, Inc. (Hearing Aids by Zounds)
• Karen Pendleton, APRN, CNP
• Chun Wei Peng, DMD
• Jaylen Evin Pennisson, DO
• Jianna L Penno

• Physical Therapy Assistant in Warwick, RI
• Providers in Warwick, RI by specialty
• Physical Therapy Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2017; 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.