Active NPI
Ricardo Plascencia, PTA
- Physical Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1740734532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 12440A
- Practice address
- 6036 N 19TH Ave
Ste 303
Phoenix, AZ 85015-2106 - Phone
- (602) 795-8441
- Fax
- (602) 795-8447
- NPI assigned
- Aug 9, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 12440A | AZ | Primary |
Addresses
Primary practice location
6036 N 19TH Ave
Ste 303
Phoenix, AZ 85015-2106
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12440A | AZ | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ati Holdings of Arizona, LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1470700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1740734532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6036 N 19TH AVE",
"address_2": "STE 303",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850152106",
"telephone_number": "602-795-8441",
"fax_number": "602-795-8447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLASCENCIA",
"first_name": "RICARDO",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-09",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "12440A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.