Travis Tanasse, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6910 Douglas Blvd Ste D
Granite Bay, CA 95746-6276

Phone

(916) 318-6964

Fax

(916) 318-6965

NPI assigned

Mar 2, 2010

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Dynamic Physical Therapy IncGroup PAC ID 2567768880, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Pro Dynamic Physical Therapy Inc.

  • Physical Therapist
  • Granite Bay, CA
  • NPI 1437522455
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1811210040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD STE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-318-6964",
            "fax_number": "916-318-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 DOUGLAS BLVD STE D",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466276",
            "telephone_number": "916-318-6964",
            "fax_number": "916-318-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANASSE",
        "first_name": "TRAVIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Suprai, D.C.
• Denise Lora Sweeney, MEDICAL DOCTOR
• Synergy Speech Therapy LLC
• Talya MD Corp
• Mark Tambellini, M.D.
• Sonali Tandel
• Tavallaei, D.M.D., Corporation
• Taylor Alicia Tavares, OTD, OTR/L
• Carly Taylor
• Michael Herbert Taylor, M.D.

• Physical Therapist in Granite Bay, CA
• Providers in Granite Bay, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.