Individual provider Active NPI

Jayesh Mahesh Bellara

  • Physical Therapist
  • Los Banos, CA
National Provider Identifier
1861073280
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-300339 Issued in CA
Practice address
1400 S Mercey Springs Rd Ste I
Los Banos, CA 93635-4928
Phone
(209) 710-1011
NPI assigned
Apr 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12692 CT
Physical Therapist 225100000X PT-300339 CA Primary

Addresses

Primary practice location

1400 S Mercey Springs Rd Ste I
Los Banos, CA 93635-4928

Mailing address

1881 Summit Dr
Los Banos, CA 93635-8308
Phone (201) 780-6509

Other practice location 1

14 Westport Ave
Norwalk, CT 06851-3915
Phone (208) 845-8000

Other names 1

  • Jayesh M Bellara Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210628002009 CA Practitioner - Physical Therapist in Private Practice 0244631281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
PT-300339CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Jun 21, 2021 Accepting new patients
Gold Country Therapies, Inc PastSince Jan 1, 2015 Accepting new patients

Locations

1400 S Mercey Springs Rd
Ste I
Los Banos, CA 93635
Phone (209) 710-1011

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

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 2

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1861073280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 SUMMIT DR",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936358308",
            "telephone_number": "201-780-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MERCEY SPRINGS RD STE I",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354928",
            "telephone_number": "209-710-1011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Westport Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068513915",
            "country_code": "US",
            "telephone_number": "208-845-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLARA",
        "first_name": "JAYESH",
        "middle_name": "MAHESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-16",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12692",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT-300339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYESH",
            "last_name": "BELLARA",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.