Tyler Michael Bacarro

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299436 Issued in CA

Practice address

1099 D St Ste 105
San Rafael, CA 94901-2839

Phone

(415) 532-8335

Fax

(415) 721-7346

NPI assigned

Dec 16, 2020

Last updated

Dec 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The University of Texas Southwestern Medical Center at Dallas

  • Physical Therapist
  • Dallas, TX
  • NPI 1386619237
  NPD (past)

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1922694660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 9TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941182208",
            "telephone_number": "858-997-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 D ST STE 105",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012839",
            "telephone_number": "415-532-8335",
            "fax_number": "415-721-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACARRO",
        "first_name": "TYLER",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Azarpira
• Azen Health Inc
• Dalia Sharona Azizi, PA STUDENT
• Jeffrey Babes
• Margarita Baca, N.P.
• Sharyn Baccei
• Jasmine M. Bachtiger, D.M.D.
• Mahnaz Badihian, D.D.S.
• Milad Bahai
• Ginny Bahr, LPCC

• Physical Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.