Active NPI
Elizabeth G Riley, PT
- Physical Therapist
- Soquel, CA
National Provider Identifier
1902939556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11568
- Practice address
- 2901 Park Ave
Ste B1
Soquel, CA 95073-2831 - Phone
- (831) 706-2085
- Fax
- (831) 417-3799
- NPI assigned
- Mar 13, 2007
- Last updated
- Feb 27, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT11568 | CA | Primary |
Addresses
Primary practice location
2901 Park Ave
Ste B1
Soquel, CA 95073-2831
Mailing address
1106 Walnut St
Ste 110
San Luis Obispo, CA 93401-2416
Phone (805) 788-0805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT11568 | Other | CA | MED LICENSE # |
Other names 1
- Elizabeth Kraatz
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11568 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balance Therapy Inc | Physical Therapist | Past | Accepting new patients |
| Sebastopol Physical Therapy and Pilates Studio | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Sebastopol, CA
- NPI 1538201546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1902939556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 WALNUT ST",
"address_2": "STE 110",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012416",
"telephone_number": "805-788-0805",
"fax_number": "805-788-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 PARK AVE",
"address_2": "STE B1",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732831",
"telephone_number": "831-706-2085",
"fax_number": "831-417-3799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "ELIZABETH",
"middle_name": "G",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT11568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED LICENSE #",
"identifier": "PT11568",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "KRAATZ",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.