Individual provider Active NPI

Benjamin Larson, DPT

  • Physical Therapist
  • Visalia, CA
National Provider Identifier
1760875843
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42353 Issued in CA
Practice address
4930 W Kaweah CT
203
Visalia, CA 93277-8324
Phone
(559) 713-6806
Fax
(559) 713-6809
NPI assigned
Mar 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42353 CA Primary

Addresses

Primary practice location

4930 W Kaweah CT
203
Visalia, CA 93277-8324

Mailing address

368 W Olive Ave
Porterville, CA 93257-3318
Phone (559) 782-1501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514002572 CA Practitioner - Physical Therapist in Private Practice 6204156243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1150 W Morton Ave
Suite B
Porterville, CA 93257-1940
Phone (559) 782-1501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42353CAMDGeneral Practice Dentistry
PT42353CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Rehabilitation & Orthopedic Physical Therapy Inc Physical Therapist CurrentSince Mar 31, 2015 Accepting new patients
Precision Rehabilitation & Orthopedic Physical Therapy Inc Physical Therapist CurrentSince Mar 31, 2015 Accepting new patients
Precision Rehabilitation & Orthopedic Physical Therapy Past Accepting new patients

Locations

860 Sequoia Ave
Ste A
Lindsay, CA 93247

1150 W Morton Ave
Ste B
Porterville, CA 93257
Phone (559) 782-1501

368 W Olive Ave
Porterville, CA 93257
Phone (559) 782-1501

4930 W Kaweah Ct
Ste 203
Visalia, CA 93277
Phone (559) 713-6806

1870 S Central St
Visalia, CA 93277
Phone (559) 636-1200

701 W Center Ave
Visalia, CA 93291

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": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1760875843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 W OLIVE AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573318",
            "telephone_number": "559-782-1501",
            "fax_number": "559-782-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 W KAWEAH CT",
            "address_2": "203",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932778324",
            "telephone_number": "559-713-6806",
            "fax_number": "559-713-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-12",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT42353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.