Jesse Balderas, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2023208 Issued in TX

Practice address

920 E Avenue L
Silsbee, TX 77656-5014

Phone

(409) 385-5571

NPI assigned

Feb 11, 2019

Last updated

Feb 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1831655240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 CLUB LAKE DR",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783827376",
            "telephone_number": "361-463-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E AVENUE L",
            "city": "SILSBEE",
            "state": "TX",
            "postal_code": "776565014",
            "telephone_number": "409-385-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERAS",
        "first_name": "JESSE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2023208",
            "primary": true
        },
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "TX",
            "license": "2023208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REHAB",
            "identifier": "A63821026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY",
            "identifier": "A63821026",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alpha Rescue EMS
• Hannah Wright Alston, MS CCC SLP
• Jonathan Mawunyo Ankutse, PHARM.D.; M.S.
• Alan A Antenorcruz, PT
• Harriet Hays Armstrong, D.M.D.
• Barri Hoffman, FNP, P.L.L.C. (Head to Toe Family Healthcare)
• Tracy Bell, MA LPC
• Nellie Bernard
• Christopher Blackwood
• Blount Kimball Medical Optometry PA (Texas State Optical Silsbee)

• Physical Therapy Assistant in Silsbee, TX
• Providers in Silsbee, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.