Individual provider Active NPI

Tyler F Eshleman, MSPT

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1063575090
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40092 Issued in CA
Practice address
100 N First St
Suite 103
Burbank, CA 91502-1845
Phone
(818) 846-7100
Fax
(818) 846-7101
NPI assigned
Dec 19, 2006
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 0250941 NY
Physical Therapist 225100000X 40092 CA Primary

Addresses

Primary practice location

100 N First St
Suite 103
Burbank, CA 91502-1845

Mailing address

100 N First St
Suite 103
Burbank, CA 91502-1845
Phone (818) 846-7100

Other identifiers 2

IdentifierTypeStateIssuer
10062514OtherNYCDPHP
7071440OtherNYAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025094NYMDClinical Psychologist
40092CAMDGeneral Practice Dentistry
25094NYMDPharmacist
0250941NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Physical Therapy PLLC PastSince Sep 18, 2000 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1063575090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N FIRST ST",
            "address_2": "SUITE 103",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021845",
            "telephone_number": "818-846-7100",
            "fax_number": "818-846-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N FIRST ST",
            "address_2": "SUITE 103",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021845",
            "telephone_number": "818-846-7100",
            "fax_number": "818-846-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHLEMAN",
        "first_name": "TYLER",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "0250941",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10062514",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7071440",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.