Blake William Baumgartner
Individual provider Active NPI Physical Therapist · Newhall, CA
NPI 1720811300 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1720811300
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 306739 (CA)
- Practice address
- 24355 Lyons Ave Ste 100
Newhall, CA 91321-2332 - Phone
- (661) 803-9997
- NPI assigned
- Aug 21, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bandb Physical Therapy, Inc
Practice addresses (Care Compare)
24355 Lyons Ave
Suite 100
Newhall, CA 91321-2332
Phone (661) 290-2884
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241106002399 | CA | Practitioner - Physical Therapist in Private Practice | 4082148598 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306739 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| B&B Physical Therapy, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
24355 Lyons Ave
Ste 100
Santa Clarita, CA 91321
Phone (661) 255-6644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 306739 | CA | Yes |
Addresses
Primary practice location
24355 Lyons Ave Ste 100
Newhall, CA 91321-2332
Mailing address
24355 Lyons Ave Ste 100
Newhall, CA 91321-2332
Other providers in Newhall, CA
- Barbara B Wilson
- Steven Harvey Baron
- Marisol Barrera
- Barte Medical Group, Inc
- Felix M Barte
- Behavioral Care Network
- Kevin Bell
- Samuel Beltran
- Meredith Atlas Benzion
- Bestyle Home Care Services Inc.
All providers in Newhall, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.