Individual provider Active NPI

Joscelyn C Washington, MPT

  • Physical Therapist
  • Montclair, CA
National Provider Identifier
1083755680
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28944 Issued in CA
Practice address
4959 Palo Verde St 109C
Montclair, CA 91763-2358
Phone
(909) 971-3092
Fax
(310) 861-1617
NPI assigned
Feb 8, 2007
Last updated
Sep 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28944 CA Primary
Neurology Physical Therapist 2251N0400X 28944 CA
Pediatric Physical Therapist 2251P0200X 28944 CA
Orthopedic Physical Therapist 2251X0800X 28944 CA

Addresses

Primary practice location

4959 Palo Verde St 109C
Montclair, CA 91763-2358

Mailing address

4959 Palo Verde St 109C
Montclair, CA 91763-2358
Phone (909) 971-3092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091203000136 CA Practitioner - Physical Therapist in Private Practice 7315969748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4959 Palo Verde St
Suite 109C
Montclair, CA 91763-2358
Phone (909) 971-3092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28944CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapha Physical Therapy, Inc Physical Therapist CurrentSince Nov 29, 2005 Accepting new patients
Rapha Rehabilities PastSince Sep 29, 2015 Accepting new patients

Locations

4959 Palo Verde St
Ste 104A
Montclair, CA 91763
Phone (909) 624-6878

4959 Palo Verde St
Ste 109C
Montclair, CA 91763
Phone (909) 971-3092

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1083755680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST 109C",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632358",
            "telephone_number": "909-971-3092",
            "fax_number": "310-861-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST 109C",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632358",
            "telephone_number": "909-971-3092",
            "fax_number": "310-861-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "JOSCELYN",
        "middle_name": "C",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "28944",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "28944",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "28944",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "28944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.