Rick Susick, MS PT ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT11310 Issued in CA

Practice address

169 Lynch Creek Way
Petaluma, CA 94954-2344

Phone

(707) 763-0115

Fax

(707) 763-2130

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1962599704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 SHERRI CT",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949524839",
            "telephone_number": "707-765-6392",
            "fax_number": "707-769-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LYNCH CREEK WAY",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542344",
            "telephone_number": "707-763-0115",
            "fax_number": "707-763-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSICK",
        "first_name": "RICK",
        "credential": "MS PT ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11310",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "PT11310",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 11310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT 11310",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER CERTI.",
            "identifier": "781081",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.