John Djerbaka, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 22204 Issued in CA

Practice address

17251 17TH St
Ste. a&B
Tustin, CA 92780-1970

Phone

(714) 832-2273

Fax

(714) 832-2272

NPI assigned

Feb 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ideal Therapy IncGroup PAC ID 9638422454, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ideal Therapy, Inc

  • Physical Therapy Clinic/Center
  • Orange, CA
  • NPI 1255811543
  Medicare reassignment Care Compare group NPD
• Newport Care Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Newport Beach, CA
  • NPI 1528401783

  Physical Therapist

  Medicare reassignment NPD
• Newport Care Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Los Alamitos, CA
  • NPI 1922852490
  NPD
• Scott Small, D.O., Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Tustin, CA
  • NPI 1083123400
  NPD (past)

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1003156126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17251 17TH ST",
            "address_2": "STE. A&B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801970",
            "telephone_number": "714-832-2273",
            "fax_number": "714-832-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17251 17TH ST",
            "address_2": "STE. A&B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801970",
            "telephone_number": "714-832-2273",
            "fax_number": "714-832-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJERBAKA",
        "first_name": "JOHN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-26",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 22204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaikhanh A Dinhluu, DC
• Samantha Seaton Dino, MFT
• Dio Kim Chiropractic Corporation
• Dispatchhealth-Ca, PC
• Evelyn Divinagracia, M.S. CCC-SLP
• Carmen C DO, COTA
• Jacqueline Thanhhuyen DO, M.D.
• Kevin T. DO, M.D.
• Peter DO, PHARMD
• Teresa DO

• Physical Therapist in Tustin, CA
• Providers in Tustin, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.