Individual provider Active NPI

Heidi L Gastler, DPT

  • Physical Therapist
  • Manhattan Beach, CA
National Provider Identifier
1023061470
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7572 Issued in MN
Practice address
3212 Highland Ave
Manhattan Beach, CA 90266-3888
Phone
(310) 567-2293
Fax
(310) 919-0447
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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 7572 MN Primary

Addresses

Primary practice location

3212 Highland Ave
Manhattan Beach, CA 90266-3888

Mailing address

3212 Highland Ave
Manhattan Beach, CA 90266-3888
Phone (310) 567-2293

Other identifiers 7

IdentifierTypeStateIssuer
196P6GAOtherMNBLUE CROSS BLUE SHIELD
713523800MedicaidMN
6405758OtherMNMEDICA
P00278533OtherMNRAILROAD MEDICARE
125107OtherMNUCARE
936131043346OtherMNPREFERRED ONE
HP53380OtherMNHEALTH PARTNERS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120511000231 CA Practitioner - Physical Therapist in Private Practice 1254360936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3212 Highland Ave
Manhattan Beach, CA 90266-3888
Phone (310) 567-2293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38261CAMDDentist
7572MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain to Sea Physical Therapy Inc Physical Therapist CurrentSince Nov 1, 2016 Accepting new patients
Frank E Kaden D C Chiropractic Inc CurrentSince Aug 1, 2015 Accepting new patients
Blue Water Enterprises, Inc. Physical Therapist Past Accepting new patients

Locations

1035 Aviation Blvd
Hermosa Beach, CA 90254
Phone (310) 251-0862

Organizations & group practices 3

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1023061470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 HIGHLAND AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663888",
            "telephone_number": "310-567-2293",
            "fax_number": "310-919-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 HIGHLAND AVE",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663888",
            "telephone_number": "310-567-2293",
            "fax_number": "310-919-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTLER",
        "first_name": "HEIDI",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "196P6GA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713523800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6405758",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00278533",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "125107",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "936131043346",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP53380",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.