Individual provider Active NPI

John Chris Besonis, P.T.

  • Physical Therapist
  • San Rafael, CA
National Provider Identifier
1982605903
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1181020 Issued in TX
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

Updated by the provider on Sep 19, 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 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 Other name

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

LicenseStateTypeSpecialty
1181020TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Physical Therapy, Inc. PastSince Nov 1, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.