Individual provider Active NPI

Christopher J Rosales, MPT, MPH

  • Physical Therapist
  • Santa Rosa, CA
National Provider Identifier
1841419223
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21408 Issued in CA
Practice address
3033 Cleveland Ave
#205
Santa Rosa, CA 95403-2126
Phone
(707) 542-8313
NPI assigned
Apr 24, 2007
Last updated
Oct 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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 PT21408 CA Primary

Addresses

Primary practice location

3033 Cleveland Ave
#205
Santa Rosa, CA 95403-2126

Mailing address

3033 Cleveland Ave
#205
Santa Rosa, CA 95403-2126
Phone (707) 542-8313

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ64164ZOtherCABLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050126000792 CA Practitioner - Physical Therapist in Private Practice 4486604576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

151 Lynch Creek Way
Petaluma, CA 94954-6703

65 Larkfield Maples CT
Santa Rosa, CA 95403-1486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoma Hills Physical Therapy, Inc. Physical Therapist CurrentSince Jan 4, 2021 Accepting new patients
Santa Rosa Physical Therapy Physical Therapist Past Accepting new patients

Locations

151 Lynch Creek Way
Petaluma, CA 94954
Phone (707) 364-3527

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1841419223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 CLEVELAND AVE",
            "address_2": "#205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032126",
            "telephone_number": "707-542-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 CLEVELAND AVE",
            "address_2": "#205",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032126",
            "telephone_number": "707-542-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MPT, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT21408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "ZZZ64164Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.