Individual provider Active NPI

Ikea Zorie Alexandra Clark, DPT, PT

  • Physical Therapist
  • Roseville, CA
National Provider Identifier
1013707553
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307979 Issued in CA
Practice address
151 N Sunrise Ave
Roseville, CA 95661-2924
Phone
(916) 720-2067
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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 307979 CA Primary

Addresses

Primary practice location

151 N Sunrise Ave
Roseville, CA 95661-2924

Mailing address

1710 V St Apt 11
Sacramento, CA 95818-1638
Phone (919) 352-5159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250613002654 CA Practitioner - Physical Therapist in Private Practice 5294246591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

151 N Sunrise Ave
Suite 1001
Roseville, CA 95661-2930
Phone (916) 720-2067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307979CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince May 26, 2025 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince May 26, 2025 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

151 N Sunrise Ave
Ste 1001
Roseville, CA 95661
Phone (916) 419-9900

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

5850 Canoga Ave
Ste 120
Woodland Hills, CA 91367
Phone (747) 255-4089

Organizations & group practices 2

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1013707553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 V ST APT 11",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958181638",
            "telephone_number": "919-352-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612924",
            "telephone_number": "916-720-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "IKEA",
        "middle_name": "ZORIE ALEXANDRA",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.