NPIMap

Individual provider Active NPI

Alexis Christian Bautista Cortez, DPT

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1740631985
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299833 Issued in CA
Practice address
4660 Spyres Way
Modesto, CA 95356-9804
Phone
(209) 578-3290
NPI assigned
Jun 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Physical Therapist 225100000X 299833 CA Primary

Addresses

Primary practice location

4660 Spyres Way
Modesto, CA 95356-9804

Mailing address

4660 Spyres Way
Modesto, CA 95356-9804
Phone (209) 578-3290

Other names 1

  • Alexis Christian Cortez-Bautista Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
299833CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Physical, Occupational, Speech and Hand Therapy, Inc. Physical Therapist PastSince Jan 29, 2023 Accepting new patients
Aegis Treatment Centers, LLC PastSince Jul 25, 2019 Accepting new patients
Aegis Treatment Centers, LLC PastSince Jul 25, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1740631985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569804",
            "telephone_number": "209-578-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569804",
            "telephone_number": "209-578-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTEZ",
        "first_name": "ALEXIS",
        "middle_name": "CHRISTIAN BAUTISTA",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "CORTEZ-BAUTISTA",
            "middle_name": "CHRISTIAN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.