Individual provider Active NPI

Sergio Salazar, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1043089469
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305366 Issued in CA
Practice address
585 Saturn Blvd
San Diego, CA 92154-4721
Phone
(619) 591-1190
NPI assigned
Dec 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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 305366 CA Primary

Addresses

Primary practice location

585 Saturn Blvd
San Diego, CA 92154-4721

Mailing address

608 Vista San Pedro Martir
San Diego, CA 92154-5664

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123004743 CA Practitioner - Physical Therapist in Private Practice 8426400680 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centro de Salud de la Comunidad de San Ysidro Inc CurrentSince Dec 20, 2024 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. CurrentSince Dec 20, 2024 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 26, 2023 Accepting new patients
Centro de Salud de la Comunidad de San Ysidro, Inc. Current Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 26, 2023 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

1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780

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

1136 D Ave
National City, CA 91950
Phone (619) 336-2300

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

585 Saturn Blvd
Ste A
San Diego, CA 92154
Phone (619) 591-1190

3364 Beyer Blvd
Ste 102103
San Ysidro, CA 92173
Phone (619) 205-4585

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1043089469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 VISTA SAN PEDRO MARTIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921545664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SATURN BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544721",
            "telephone_number": "619-591-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "SERGIO",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.