Individual provider Active NPI

Troy Corcoran, LPTA

  • Physical Therapy Assistant
  • Pacific Grove, CA
National Provider Identifier
1811428352
Registry record updated Mar 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
11110 Issued in CA
Practice address
581 Lighthouse Ave
Pacific Grove, CA 93950-2646
Phone
(831) 657-0177
NPI assigned
Mar 26, 2017
Last updated
Mar 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 11110 CA Primary

Addresses

Primary practice location

581 Lighthouse Ave
Pacific Grove, CA 93950-2646

Mailing address

581 Lighthouse Ave
Pacific Grove, CA 93950
Phone (831) 657-0177

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11110CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
In Stride Physical Therapy & Rehab, Inc. PastSince Feb 28, 2014 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490486400000",
    "number": "1811428352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 LIGHTHOUSE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "93950",
            "telephone_number": "831-657-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 LIGHTHOUSE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939502646",
            "telephone_number": "831-657-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "TROY",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "11110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2017; 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.