Aaron David Bass-Cetinich, PT
Individual provider Active NPI Physical Therapist · Berkeley, CA
NPI 1760103766 · NPPES record last updated Sep 7, 2022
Key facts
- NPI
- 1760103766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT302687 (CA)
- Practice address
- 2001 Fourth St
Berkeley, CA 94710 - Phone
- (510) 833-6880
- NPI assigned
- Sep 7, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sports and Orthopedic Leaders Physical Therapy Inc
Practice addresses (Care Compare)
2001 4TH St
Berkeley, CA 94710-1912
Phone (510) 833-6880
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220924000095 | CA | Practitioner - Physical Therapist in Private Practice | 8426433608 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT302687 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports & Orthopedic Leaders Physical Therapy, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
2001 4th St
Berkeley, CA 94710
Phone (510) 833-6880
4341 Piedmont Ave
Ste 103
Oakland, CA 94611
Phone (510) 547-1630
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT302687 | CA | Yes |
Addresses
Primary practice location
2001 Fourth St
Berkeley, CA 94710
Mailing address
1421 66TH St
Berkeley, CA 94702-2702
Phone (510) 847-6769
Other providers in Berkeley, CA
- Chelsey Maxine Bartlett
- Renee Bartlett
- Yakov Barton
- Ceren Barut
- Stephen A. Baskin
- Amanda Bassard
- Kelly Anne Bassin
- Kathryn Rae Bastable
- Runa Basu
- James P Bates
All providers in Berkeley, 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 Sep 7, 2022. 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.