Individual provider Active NPI

Gabrielle Thomason

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1093274623
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
296373 Issued in CA
Practice address
9888 Carmel Mountain Rd Ste J
San Diego, CA 92129-2807
Phone
(858) 207-4481
Fax
(858) 216-8496
NPI assigned
Mar 13, 2019
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 296373 CA Primary

Addresses

Primary practice location

9888 Carmel Mountain Rd Ste J
San Diego, CA 92129-2807

Mailing address

3070 Madison St
Carlsbad, CA 92008-2310
Phone (760) 434-6100

Other practice location 1

3737 Moraga Ave
San Diego, CA 92117-5404
Phone (858) 270-0981

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230203000410 CA Practitioner - Physical Therapist in Private Practice 6507238383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

3070 Madison St
Carlsbad, CA 92008-2310
Phone (760) 434-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Jean Boutelle/Carlsbad Physical Therapy Physical Therapist CurrentSince Sep 19, 2023 Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist CurrentSince Sep 19, 2023 Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist Current Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist Past Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist Past Accepting new patients

Locations

3070 Madison St
Carlsbad, CA 92008
Phone (760) 434-6100

1815 E Valley Pkwy
Ste 5
Escondido, CA 92027
Phone (760) 233-9655

850 Main St
Ste 105
Ramona, CA 92065
Phone (760) 789-1424

9888 Carmel Mountain Rd
Ste J
San Diego, CA 92129
Phone (858) 207-4481

935 W San Marcos Blvd
Ste 102
San Marcos, CA 92078
Phone (760) 471-2440

9830 Prospect Ave
Ste A
Santee, CA 92071
Phone (619) 448-4860

2067 W Vista Way
Ste 185
Vista, CA 92083
Phone (760) 631-5888

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, 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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1093274623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MADISON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082310",
            "telephone_number": "760-434-6100",
            "fax_number": "760-434-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9888 CARMEL MOUNTAIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292807",
            "telephone_number": "858-207-4481",
            "fax_number": "858-216-8496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Moraga Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921175404",
            "country_code": "US",
            "telephone_number": "858-270-0981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296373",
            "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 Oct 17, 2023; 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.