Individual provider Active NPI

Eric Bartolo, DPT

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1962952077
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
43472 Issued in CA
Practice address
5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804
Phone
(818) 986-4100
NPI assigned
Oct 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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 43472 CA Primary

Addresses

Primary practice location

5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804

Mailing address

5353 Balboa Blvd
Suite 202
Encino, CA 91316-2804
Phone (818) 986-4100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170116000106 CA Practitioner - Physical Therapist in Private Practice 7416239025 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Edge Physical Therapy Inc Physical Therapist CurrentSince Sep 14, 2020 Accepting new patients

Locations

253 N Santa Anita Ave
Arcadia, CA 91006
Phone (626) 294-0070

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1962952077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-986-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD",
            "address_2": "SUITE 202",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-986-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLO",
        "first_name": "ERIC",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.