Dylan Pace, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT299947 Issued in CA

Practice address

1632 Puente Ave
Baldwin Park, CA 91706-5952

Phone

(626) 430-2300

NPI assigned

Mar 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690

  ID, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1821675844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11021 CEDAR CREEK DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917377855",
            "telephone_number": "909-912-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 PUENTE AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065952",
            "telephone_number": "626-430-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "DYLAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-10-13",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7619",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT299947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orlome Dental Group Inc
• Joshua Ortega
• Louis Albert Ortega, PHARMD
• Alicia M Ortiz, RDN
• Araceli Osorio, PT
• Ruth Leticia Padilla, L.C.S.W.
• Aswini Padmanabhan, MD
• Marisol Palomera
• Jeanne P Pan
• Laura Janelle Panama, PT

• Physical Therapist in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.