Rico Andres Buentello, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1262165 Issued in TX

Practice address

12709 Toepperwein Rd
Suite 101
Live Oak, TX 78233-3258

Phone

(210) 477-5151

Fax

(210) 477-5152

NPI assigned

Aug 13, 2015

Last updated

Aug 19, 2015By 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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Georgetown, TX
  • NPI 1952531154
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1750757787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD",
            "address_2": "SUITE 101",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333258",
            "telephone_number": "210-477-5151",
            "fax_number": "210-477-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12709 TOEPPERWEIN RD",
            "address_2": "SUITE 101",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333258",
            "telephone_number": "210-477-5151",
            "fax_number": "210-477-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUENTELLO",
        "first_name": "RICO",
        "middle_name": "ANDRES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-13",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1262165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgette Brooks
• Forrest Jett Brooks
• Shelvy Brown Sr., BS, PHD
• Bsisa Neuromonitoring, PLLC
• Bsisa PLLC (Brain and Spine Institute of San Antonio)
• Anaya Bullock
• Tanner Burke
• Brittney Ann Burns
• Jeremy Wayne Burns, FNP
• Christopher John Busken, M.D.

• Physical Therapist in Live Oak, TX
• Providers in Live Oak, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.