Individual provider Active NPI

Ryan Robert Mendiola Claros, DPT

  • Physical Therapist
  • Menifee, CA
National Provider Identifier
1811245541
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 39454 Issued in CA
Practice address
30141 Antelope Rd
Ste. a
Menifee, CA 92584-7001
Phone
(951) 723-1866
Fax
(951) 723-1867
NPI assigned
Aug 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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 PT 39454 CA Primary

Addresses

Primary practice location

30141 Antelope Rd
Ste. a
Menifee, CA 92584-7001

Mailing address

24630 Washington Ave
Ste. 200
Murrieta, CA 92562-6131
Phone (951) 696-9353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 39454CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All Star Physical Therapy Physical Therapist PastSince Oct 13, 2014 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1811245541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE",
            "address_2": "STE. 200",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626131",
            "telephone_number": "951-696-9353",
            "fax_number": "951-973-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30141 ANTELOPE RD",
            "address_2": "STE. A",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925847001",
            "telephone_number": "951-723-1866",
            "fax_number": "951-723-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAROS",
        "first_name": "RYAN ROBERT",
        "middle_name": "MENDIOLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 39454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.