Active NPI
John Chris Besonis, P.T.
- Physical Therapist
- San Rafael, CA
National Provider Identifier
1982605903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1181020
- Practice address
- 165 N Redwood Dr
Suite 120
San Rafael, CA 94903-1969 - Phone
- (415) 499-0278
- Fax
- (415) 499-0297
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1181020 | TX | Primary |
Addresses
Primary practice location
165 N Redwood Dr
Suite 120
San Rafael, CA 94903-1969
Mailing address
PO Box 1739
Bastrop, TX 78602
Phone (512) 708-0803
Other names 1
- John Christain Besonis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1181020 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marin Physical Therapy, Inc. | Past | Accepting new patients |
Interoperability endpoints
- chris.besonis.1@8363.direct.athenahealth.com
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.
-
- Specialist
- San Rafael, CA
- NPI 1275658148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505779200000",
"number": "1982605903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1739",
"city": "BASTROP",
"state": "TX",
"postal_code": "78602",
"telephone_number": "512-708-0803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 N REDWOOD DR",
"address_2": "SUITE 120",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031969",
"telephone_number": "415-499-0278",
"fax_number": "415-499-0297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BESONIS",
"first_name": "JOHN",
"middle_name": "CHRIS",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2017-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1181020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOHN",
"last_name": "BESONIS",
"middle_name": "CHRISTAIN",
"credential": "P.T.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.