Individual provider Active NPI

Tyler Finfrock, PT, DPT

  • Physical Therapist
  • Modesto, CA
National Provider Identifier
1932647005
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292742 Issued in CA
Practice address
4028 Dale Rd
Suite 101
Modesto, CA 95356-9561
Phone
(209) 312-9739
NPI assigned
Feb 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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 292742 CA Primary

Addresses

Primary practice location

4028 Dale Rd
Suite 101
Modesto, CA 95356-9561

Mailing address

2713 Amadeus Dr
Modesto, CA 95358-8850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170403000642 CA Practitioner - Physical Therapist in Private Practice 9436434594 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Physical Therapy Institute, Inc. CurrentSince Feb 21, 2017 Accepting new patients

Locations

4028 Dale Rd
Ste 101
Modesto, CA 95356
Phone (209) 312-9739

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": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1932647005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 AMADEUS DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953588850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 DALE RD",
            "address_2": "SUITE 101",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569561",
            "telephone_number": "209-312-9739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINFROCK",
        "first_name": "TYLER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.