Individual provider Active NPI

Michael Woodard, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1083371314
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301372 Issued in CA
Practice address
585 Saturn Blvd Ste a
San Diego, CA 92154-4721
Phone
(619) 591-1190
NPI assigned
Nov 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 301372 CA Primary

Addresses

Primary practice location

585 Saturn Blvd Ste a
San Diego, CA 92154-4721

Mailing address

4178 32ND St Apt 8
San Diego, CA 92104-2067
Phone (805) 757-3744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211202001602 CA Practitioner - Physical Therapist in Private Practice 3779973904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

585 Saturn Blvd
Suite a
San Diego, CA 92154-4721
Phone (619) 591-1190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Nov 22, 2021 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Nov 22, 2021 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

552 S Paseo Dorotea
Ste 4
Palm Springs, CA 92264
Phone (760) 325-5945

585 Saturn Blvd
Ste A
San Diego, CA 92154
Phone (619) 591-1190

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

Organizations & group practices 2

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": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1083371314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4178 32ND ST APT 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042067",
            "telephone_number": "805-757-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SATURN BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544721",
            "telephone_number": "619-591-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301372",
            "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 Nov 22, 2021; 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.