Jorge Bastidas Caceres, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2275 S Main St
102
Corona, CA 92882-5303

Phone

(951) 273-7742

NPI assigned

Dec 13, 2012

Last updated

May 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bodybasics Physical Therapy, Inc.

  dba Body Basics Physical Therapy

  • Physical Therapy Clinic/Center
  • Norco, CA
  • NPI 1487651097
  Medicare reassignment NPD
• Bodybasics Physical Therapy, Inc.

  dba Body Basics Physical Therapy

  • Physical Therapy Clinic/Center
  • Corona, CA
  • NPI 1194904243
  NPD (past)

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1902142318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-273-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 S MAIN ST",
            "address_2": "102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825303",
            "telephone_number": "951-273-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACERES",
        "first_name": "JORGE",
        "middle_name": "BASTIDAS",
        "credential": "PT, MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-13",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT35690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudy Cabaccang, CADC-I, CDVA
• Ronald M Cabal, RN, BSN
• Abraham Caballero, RN
• Dominik Cabeza
• Angelo Cacciatore, DMD
• Abel Cachola, PHARMD
• Thomas John Cachur Jr., D.O.
• Cade's Home Care Services LLC
• Miranda Cadenas, PPS SCHOOL PSYCH
• Daniel Cahalin, BCBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.