NPIMap

Organization Active NPI

P.S.M.R.C., LLC

Doing business as Peninsula Sports Medicine and Rehabilitation Center

  • Physical Therapist
  • Daly City, CA
National Provider Identifier
1871666974
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
P.S.M.R.C., LLC
Doing business as
Peninsula Sports Medicine and Rehabilitation Center
Practice address
2945 Junipero Serra Blvd
Daly City, CA 94014-2549
Phone
(650) 755-8830
Fax
(650) 755-8147
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Authorized official

Name
Susan Rauenbuehler, PTNPI 1821032806
Title
Clinical Director
Phone
(650) 755-8830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2945 Junipero Serra Blvd
Daly City, CA 94014-2549

Mailing address

2945 Junipero Serra Blvd
Daly City, CA 94014-2549
Phone (650) 755-8830

Other identifiers 1

IdentifierTypeStateIssuer
GZ817AOtherCAMEDICARE PTAN

Other names 1

  • Peninsula Sports Medicine and Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000565 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0446495741 Receives reassigned benefits from 6 practitioners
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1871666974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 JUNIPERO SERRA BLVD",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142549",
            "telephone_number": "650-755-8830",
            "fax_number": "650-755-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 JUNIPERO SERRA BLVD",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142549",
            "telephone_number": "650-755-8830",
            "fax_number": "650-755-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.S.M.R.C., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "RAUENBUEHLER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "650-755-8830",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GZ817A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Sports Medicine and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.