Individual provider Active NPI

Jeremias Torres II

  • Physical Therapist
  • Gallup, NM
National Provider Identifier
1932517786
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1908 Issued in NM
Practice address
106 Boardman Dr
Gallup, NM 87301-4801
Phone
(505) 722-9188
Fax
(505) 926-0910
NPI assigned
Jul 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1908 NM Primary

Addresses

Primary practice location

106 Boardman Dr
Gallup, NM 87301-4801

Mailing address

106 Boardman Dr
Gallup, NM 87301-4801
Phone (505) 722-9188

Other practice location 1

5345 Wyoming Blvd NE Ste 106
Albuquerque, NM 87109-3193
Phone (505) 595-3120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150102000710 NM Practitioner - Physical Therapist in Private Practice 1658593348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Mobz LLCGroup PAC ID 4789806464, 2 clinicians

Practice addresses (Care Compare)

106 Boardman Dr
Gallup, NM 87301-4801
Phone (505) 926-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1908NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Mobz LLC Physical Therapist CurrentSince Aug 30, 2014 Accepting new patients

Locations

5345 Wyoming Blvd NE
Ste 106
Albuquerque, NM 87109
Phone (505) 595-3120

106 Boardman Dr
Gallup, NM 87301
Phone (505) 722-9188

211 E Aztec Ave
Gallup, NM 87301
Phone (505) 288-3090

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1932517786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BOARDMAN DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014801",
            "telephone_number": "505-722-9188",
            "fax_number": "505-926-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BOARDMAN DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014801",
            "telephone_number": "505-722-9188",
            "fax_number": "505-926-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5345 Wyoming Blvd NE Ste 106",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871093193",
            "country_code": "US",
            "telephone_number": "505-595-3120",
            "fax_number": "505-926-0910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORRES",
        "first_name": "JEREMIAS",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.