Individual provider Active NPI

Celeste Tafolla

  • Physical Therapist
  • Patterson, CA
National Provider Identifier
1871317271
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307201 Issued in CA
Practice address
1700 Keystone Pacific Pkwy Unit C2
Patterson, CA 95363-8874
Phone
(209) 895-4206
NPI assigned
Nov 12, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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 307201 CA Primary

Addresses

Primary practice location

1700 Keystone Pacific Pkwy Unit C2
Patterson, CA 95363-8874

Mailing address

1700 Keystone Pacific Pkwy Unit C2
Patterson, CA 95363-8874
Phone (209) 895-4206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250115002730 CA Practitioner - Physical Therapist in Private Practice 2769910918 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
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)

1700 Keystone Pacific Pkwy
Unit C2
Patterson, CA 95363-8874
Phone (209) 895-4206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307201CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients

Locations

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

1700 Keystone Pacific Pkwy
Unit C2
Patterson, CA 95363
Phone (209) 881-9274

Organizations & group practices 4

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": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1871317271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 KEYSTONE PACIFIC PKWY UNIT C2",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638874",
            "telephone_number": "209-895-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 KEYSTONE PACIFIC PKWY UNIT C2",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953638874",
            "telephone_number": "209-895-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAFOLLA",
        "first_name": "CELESTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patterson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.