Aegis Group Practice LLC
Organization Active NPI Physical Therapist · El Dorado Hills, CA
NPI 1053192559 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1053192559
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- AEGIS GROUP PRACTICE LLC
- Practice address
- 4240 Town Center Blvd
El Dorado Hills, CA 95762-7143 - Phone
- (479) 201-6091
- NPI assigned
- Oct 10, 2023
- Organization subpart
- No
Authorized official
- Name
- Tracy McCall
- Title
- Credentialing
- Phone
- (479) 201-6091
Other NPIs on the same Medicare enrollment 5
Member of 1
Practitioners 2
-
David Hug, PT
-
Sarah Jean Zabek, OTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211229002141 | CA | Part B Supplier - Clinic/Group Practice | 5193036432 |
Receives reassigned benefits from 8 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Glendale, CA; La Quinta, CA; Santa Barbara, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
4240 Town Center Blvd
El Dorado Hills, CA 95762-7143
Mailing address
4933 Old Greenwood Rd
Fort Smith, AR 72903-6906
Other providers in El Dorado Hills, CA
- Action Home Nursing Services, Inc.
- Acu Om
- Karen Adkinson
- Kayla Adov
- Advanced Foothills Medics
- Afton L Arnold
- Agewell Physical Therapy
- Agewell Physical Therapy Inc
- Nelly Aghili
- Samantha Rae Agostini
All providers in El Dorado Hills, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.