Renwick Yoshio Maeda, PT MPT OCS GCFP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT15486 Issued in CA

Practice address

1600 Main St FL 2
Venice, CA 90291-3626

Phone

(888) 859-0145

NPI assigned

May 18, 2006

Last updated

Feb 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Manhattan Beach Pacific Physical Therapy Inc

  dba Pacific Physical Therapy

  • Physical Therapist
  • El Segundo, CA
  • NPI 1396799458
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1053364125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 WILSHIRE BLVD",
            "address_2": "440",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034901",
            "telephone_number": "310-315-9711",
            "fax_number": "310-315-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MAIN ST FL 2",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913626",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Wilshire Blvd",
            "address_2": "440",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904034901",
            "country_code": "US",
            "telephone_number": "310-315-9711",
            "fax_number": "310-315-9349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAEDA",
        "first_name": "RENWICK",
        "middle_name": "YOSHIO",
        "name_prefix": "Mr.",
        "credential": "PT MPT OCS GCFP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Ly
• Alexander J Macdonald
• Luciano Machado II
• Juan M Macias Jr.
• Rosalie S Maduro
• Anjali Mahoney, MD MPH
• Brisa Mahoney
• Ana Marin
• Marina Center Neurodiagnostics Inc
• Riley Marsh

• Physical Therapist in Venice, CA
• Providers in Venice, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.