Individual provider Active NPI

Donna Ella Anderson, DPT

  • Physical Therapist
  • Anaheim, CA
National Provider Identifier
1083902183
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39768 Issued in CA
Practice address
2400 E Katella Ave Ste 405
Anaheim, CA 92806-5958
Phone
(714) 712-9222
Fax
(714) 937-1314
NPI assigned
Jul 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 39768 CA Primary

Addresses

Primary practice location

2400 E Katella Ave Ste 405
Anaheim, CA 92806-5958

Mailing address

2400 E Katella Ave Ste 405
Anaheim, CA 92806-5958
Phone (714) 712-9222

Other identifiers 2

IdentifierTypeStateIssuer
1019473MedicaidVT
30399000MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108002204 CA Practitioner - Physical Therapist in Private Practice 4688845126 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

2400 E Katella Ave
Suite 405
Anaheim, CA 92806-5958
Phone (714) 712-9222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3632NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Lifetime Physical Therapy and Fitness Inc Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Past Accepting new patients

Locations

2400 E Katella Ave
Ste 405
Anaheim, CA 92806
Phone (714) 408-8071

1310 W Stewart Dr
Ste 404
Orange, CA 92868
Phone (714) 707-6466

935 E Ridgecrest Blvd
Ridgecrest, CA 93555
Phone (760) 371-1411

2001 Wilshire Blvd
Ste 310
Santa Monica, CA 90403
Phone (310) 829-3320

Organizations & group practices 5

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1083902183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 E KATELLA AVE STE 405",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065958",
            "telephone_number": "714-712-9222",
            "fax_number": "714-937-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E KATELLA AVE STE 405",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065958",
            "telephone_number": "714-712-9222",
            "fax_number": "714-937-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DONNA",
        "middle_name": "ELLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019473",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30399000",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.