Individual provider Active NPI

Victoria Kelertas, PT, OT

  • Occupational Therapist
  • Vista, CA
National Provider Identifier
1073099065
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13052 Issued in CA
Practice address
115 Main St
Vista, CA 92084-6007
Phone
(760) 726-9660
NPI assigned
Jul 13, 2018
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13052 CA Primary
Physical Therapist 225100000X 41013 CA

Addresses

Primary practice location

115 Main St
Vista, CA 92084-6007

Mailing address

265 Walnut Hills Drive
San Marcos, CA 92078

Other identifiers 2

IdentifierTypeStateIssuer
13052OtherCAOT LICENSE
41013OtherCAPT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180904001903 CA Practitioner - Occupational Therapist in Private Practice 5294085775 Reassigns benefits to 1 organization
I20251104004430 CA Practitioner - Physical Therapist in Private Practice 5294085775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Physical Therapy and Rehab PCGroup PAC ID 8729305206, 2 clinicians

Practice addresses (Care Compare)

115 Main St
Vista, CA 92084-6007
Phone (760) 726-9660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41013CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Physical Therapy and Rehab PC Physical Therapist CurrentSince Jul 25, 2018 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jan 3, 2026 Accepting new patients
Oceanside Physical Therapy P C Physical Therapist PastSince Jul 25, 2018 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

115 Main St
Vista, CA 92084
Phone (760) 726-9660

Organizations & group practices 3

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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1073099065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 WALNUT HILLS DRIVE",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "92078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846007",
            "telephone_number": "760-726-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELERTAS",
        "first_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PT, OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13052",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41013",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "13052",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT",
            "identifier": "41013",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.