Individual provider Active NPI

Andrew Dean Alfrey, PTA

  • Physical Therapy Assistant
  • Cathedral City, CA
National Provider Identifier
1992230569
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA48585 Issued in CA
Practice address
27620 Landau Blvd Ste 3
Cathedral City, CA 92234-5540
Phone
(760) 322-5090
Fax
(760) 322-9175
NPI assigned
Apr 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA48585 CA Primary

Addresses

Primary practice location

27620 Landau Blvd Ste 3
Cathedral City, CA 92234-5540

Mailing address

27620 Landau Blvd Ste 3
Cathedral City, CA 92234-5540
Phone (760) 322-5090

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA48585CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Physical Therapy Inc. PastSince Oct 1, 2005 Accepting new patients

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": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1992230569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD STE 3",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD STE 3",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFREY",
        "first_name": "ANDREW",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA48585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.