Individual provider Active NPI

Christine Weidemann, DPT

  • Physical Therapist
  • Fountain Valley, CA
National Provider Identifier
1023328416
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 36992 Issued in CA
Practice address
10900 Warner Avenue #111
Fountain Valley, CA 92708-3846
Phone
(714) 964-3337
Fax
(714) 964-8806
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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 PT 36992 CA Primary

Addresses

Primary practice location

10900 Warner Avenue #111
Fountain Valley, CA 92708-3846

Mailing address

10900 Warner Avenue #111
Fountain Valley, CA 92708-3846
Phone (714) 964-3337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170804001973 CA Practitioner - Physical Therapist in Private Practice 1658529599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Therapy SolutionsGroup PAC ID 1658331574, 11 clinicians

Practice addresses (Care Compare)

2 Corporate Plaza Dr
Suite 200
Newport Beach, CA 92660-7953
Phone (949) 722-7374

485 E 17TH St
Suite 650
Costa Mesa, CA 92627-4706
Phone (949) 722-7374

6865 Alton Pkwy
Suite 110
Irvine, CA 92618-3740
Phone (949) 679-2933

Merit-based Incentive Payment System (MIPS)

Final score
80.28 of 100Reported as group
Quality
85
Improvement activities
40
Cost
54.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 36992CAMDPhysical Therapist

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1023328416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 WARNER AVENUE #111",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083846",
            "telephone_number": "714-964-3337",
            "fax_number": "714-964-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 WARNER AVENUE #111",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083846",
            "telephone_number": "714-964-3337",
            "fax_number": "714-964-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDEMANN",
        "first_name": "CHRISTINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 36992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.