Individual provider Active NPI

Elliott Gregory Caponetti, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1083015127
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299327 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Sep 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10255 MN
Orthopedic Physical Therapist 2251X0800X PT023860 PA
Physical Therapist 225100000X 299327 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

3737 Moraga Ave Ste B117
San Diego, CA 92117-5358
Phone (858) 270-0981

Other practice location 2

1761 University Ave W
Saint Paul, MN 55104-3509
Phone (952) 222-5769

Other practice location 3

3335 Blaisdell Ave
Minneapolis, MN 55408-4429
Phone (952) 222-5769

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
10255MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Mar 4, 2023 Accepting new patients
Regents of the University of California - Ucsd Medical Group CurrentSince Mar 4, 2023 Accepting new patients
Regents of the University of California Current Accepting new patients
Therapy Partners, Inc. Physical Therapist Past Accepting new patients
Waypoint Minnesota PC Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

9400 Campus Point Dr
La Jolla, CA 92093
Phone (858) 249-3800

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 6

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": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1083015127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Moraga Ave Ste B117",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921175358",
            "country_code": "US",
            "telephone_number": "858-270-0981",
            "fax_number": "858-270-2901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1761 University Ave W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551043509",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3335 Blaisdell Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554084429",
            "country_code": "US",
            "telephone_number": "952-222-5769",
            "fax_number": "763-260-7653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPONETTI",
        "first_name": "ELLIOTT",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-09",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10255",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT023860",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299327",
            "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 Apr 26, 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.