Individual provider Active NPI

Justin Carrido, DPT

  • Orthopedic Physical Therapist
  • Chino Hills, CA
National Provider Identifier
1740936434
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
301621 Issued in CA
Practice address
15944 Los Serranos Country Club Dr Ste 250
Chino Hills, CA 91709-3992
Phone
(909) 907-0805
Fax
(909) 907-0735
NPI assigned
Feb 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 301621 CA Primary

Addresses

Primary practice location

15944 Los Serranos Country Club Dr Ste 250
Chino Hills, CA 91709-3992

Mailing address

15944 Los Serranos Country Club Dr Ste 250
Chino Hills, CA 91709-3992
Phone (909) 907-0805

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@empowerptwellness.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220406000314 CA Practitioner - Physical Therapist in Private Practice 0648666347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower Physical Therapy and Wellness, IncGroup PAC ID 6002112018, 9 clinicians

Practice addresses (Care Compare)

15944 Los Serranos Country Club Dr
Suite 250
Chino Hills, CA 91709-3992
Phone (909) 907-0805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Physical Therapy and Wellness, Inc Orthopedic CurrentSince Feb 28, 2022 Accepting new patients

Locations

5632 Philadelphia St
Ste 102
Chino, CA 91710
Phone (909) 925-0015

15944 Los Serranos Country Club Dr
Ste 250
Chino Hills, CA 91709
Phone (909) 907-0805

801 Corporate Center Dr
Ste 120
Pomona, CA 91768

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": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1740936434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15944 LOS SERRANOS COUNTRY CLUB DR STE 250",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093992",
            "telephone_number": "909-907-0805",
            "fax_number": "909-907-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15944 LOS SERRANOS COUNTRY CLUB DR STE 250",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917093992",
            "telephone_number": "909-907-0805",
            "fax_number": "909-907-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIDO",
        "first_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "301621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@empowerptwellness.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "15944 Los Serranos Country Club Dr Ste 250",
            "city": "Chino Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917093992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.