Revive Physical Therapy Professional Corporation

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVIVE PHYSICAL THERAPY PROFESSIONAL CORPORATION

Practice address

2655 Henley Pkwy Unit 2112
Tracy, CA 95377-2220

Phone

(214) 517-9435

NPI assigned

Jan 28, 2025

Organization subpart

No

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

Authorized official

Name

Shayan MoslemiNPI 1821471004

Title

Ceo

Phone

(214) 517-9435

Specialties & licenses 1

Addresses

Practitioners 1

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

• Shayan Moslemi, DPT

  • Physical Therapist
  • The Colony, TX
  • NPI 1821471004
  NPD Authorized official

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1891508685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 HENLEY PKWY UNIT 2112",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953772220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 HENLEY PKWY UNIT 2112",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953772220",
            "telephone_number": "214-517-9435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "MOSLEMI",
        "authorized_official_first_name": "SHAYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-517-9435"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Mary Rembish, MFT
• Elizabeth Ren, NP
• Dennisen Sebastian Renderos-Solorio
• Gretel Renteria
• Christina Resuello
• Erasmia Reynolds
• Hana Rha Lim, O.D.
• Anisha Richardson
• Emily Rico
• Ride and Assist LLC

• Physical Therapist in Tracy, CA
• Providers in Tracy, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.