Individual provider Active NPI

Andy Lai

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1093603466
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
308041 Issued in CA
Practice address
3425 W Victory Blvd
Burbank, CA 91505-1545
Phone
(818) 955-8855
NPI assigned
Jun 25, 2025
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 308041 CA Primary

Addresses

Primary practice location

3425 W Victory Blvd
Burbank, CA 91505-1545

Mailing address

25115 Avenue Stanford Ste B135
Valencia, CA 91355-1290
Phone (661) 250-9940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251001001345 CA Practitioner - Physical Therapist in Private Practice 6608372438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25115 Ave Stanford
Valencia, CA 91355

25115 Ave Stanford
B135
Valencia, CA 91355-1290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
308041CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vargo Physical Therapy, Inc. Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients
Vargo Physical Therapy, Inc Physical Therapist PastSince Jun 29, 2025 Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients
Vargo Physical Therapy, Inc Physical Therapist PastSince Sep 1, 2025 Accepting new patients

Locations

3425 W Victory Blvd
Burbank, CA 91505
Phone (818) 955-8855

11225 Tampa Ave
Porter Ranch, CA 91326
Phone (818) 363-9970

1240 Truman St
San Fernando, CA 91340
Phone (818) 403-6559

25115 Avenue Stanford
#B135
Valencia, CA 91355

25115 Avenue Stanford
Ste B135
Valencia, CA 91355
Phone (661) 250-9940

Organizations & group practices 4

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": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1093603466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25115 AVENUE STANFORD STE B135",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551290",
            "telephone_number": "661-250-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 W VICTORY BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051545",
            "telephone_number": "818-955-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "ANDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "308041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.