Individual provider Active NPI

Fatema Manekia Ghani, DPT

  • Physical Therapist
  • Lodi, CA
National Provider Identifier
1831238310
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33355 Issued in CA
Practice address
631 S Ham LN
Lodi, CA 95242-3532
Phone
(209) 368-7433
Fax
(209) 368-4219
NPI assigned
Feb 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 33355 CA Primary

Addresses

Primary practice location

631 S Ham LN
Lodi, CA 95242-3532

Mailing address

5104 Bengal CT
Elk Grove, CA 95757-4337
Phone (909) 228-2328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000392 CA Practitioner - Physical Therapist in Private Practice 5496859209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden Bear Physical Therapy Sports Injury Center IncGroup PAC ID 2961423082, 85 clinicians

Practice addresses (Care Compare)

631 S Ham LN
Suite B
Lodi, CA 95242-3532
Phone (209) 368-7433

Merit-based Incentive Payment System (MIPS)

Final score
67.73 of 100Reported as group
Quality
41.21
Improvement activities
40
Cost
83.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33355CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Feb 24, 2019 Accepting new patients
Sutter Gould Medical Foundation PastSince Feb 24, 2019 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

210 W Pine St
Lodi, CA 95240
Phone (209) 365-7867

631 S Ham Ln
Ste B
Lodi, CA 95242
Phone (209) 368-7433

1335 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 576-1946

1518 Coffee Rd
Ste I
Modesto, CA 95355

1222 W Colony Rd
Ste 130
Ripon, CA 95366
Phone (209) 624-1288

1906 Vista del Lago Dr
Ste A
Valley Springs, CA 95252
Phone (209) 772-0848

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, 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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831238310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5104 BENGAL CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957574337",
            "telephone_number": "909-228-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423532",
            "telephone_number": "209-368-7433",
            "fax_number": "209-368-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANI",
        "first_name": "FATEMA",
        "middle_name": "MANEKIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.