NPIMap

Organization Active NPI

Andersen Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Turlock, CA
National Provider Identifier
1891520185
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ANDERSEN PHYSICAL THERAPY, INC.
Practice address
4230 N Golden State Blvd
Turlock, CA 95382-8841
Phone
(209) 549-4626
Fax
(209) 549-4625
NPI assigned
Sep 5, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ANDERSEN PHYSICAL THERAPY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Jonathan Lyle Andersen, DPTNPI 1346326550
Title
Co-Owner
Phone
(209) 549-4626

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4230 N Golden State Blvd
Turlock, CA 95382-8841

Mailing address

PO Box 576276
Modesto, CA 95357-6276
Phone (209) 522-3523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000843 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3678520244 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Modesto, CA; Oakdale, CA; Stockton, CA; Turlock, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Anderson and Biam Phy T2 organizations share this tax ID, including this one
Part of
Anderson and Biam Phy T

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3500 Coffee Rd
Ste 3
Modesto, CA 95355
Phone (209) 549-4626

706 E F St
Oakdale, CA 95361
Phone (209) 549-4326

4230 N Golden State Blvd
Turlock, CA 95382
Phone (209) 549-4626

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1891520185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576276",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576276",
            "telephone_number": "209-522-3523",
            "fax_number": "209-549-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 N GOLDEN STATE BLVD",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953828841",
            "telephone_number": "209-549-4626",
            "fax_number": "209-549-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSEN PHYSICAL THERAPY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANDERSEN PHYSICAL THERAPY, INC.",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "209-549-4626",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.