Individual provider Active NPI

Samuel Darrigrand Pitrone

  • Physical Therapy Assistant
  • Mesa, AZ
National Provider Identifier
1992415079
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014230 Issued in AZ
Practice address
4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418
Phone
(480) 503-2373
NPI assigned
Nov 30, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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 014230 AZ Primary

Addresses

Primary practice location

4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418

Mailing address

4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Raintree
Other URL Raintree

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
014230AZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1669766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1992415079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 E BASELINE RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 E BASELINE RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064418",
            "telephone_number": "480-503-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITRONE",
        "first_name": "SAMUEL",
        "middle_name": "DARRIGRAND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "014230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Raintree",
            "affiliation": "N",
            "address_1": "4210 E Baseline Rd Ste 106",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852064418",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Raintree",
            "affiliation": "N",
            "address_1": "4210 E Baseline Rd Ste 106",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852064418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.