Individual provider Active NPI

Shayan Falatoonzadeh, DPT

  • Physical Therapist
  • Montclair, CA
National Provider Identifier
1104648088
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306850 Issued in CA
Practice address
5350 Olive St
Montclair, CA 91763-1639
Phone
(909) 497-1900
Fax
(909) 497-1900
NPI assigned
Oct 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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 306850 CA Primary

Addresses

Primary practice location

5350 Olive St
Montclair, CA 91763-1639

Mailing address

5350 Olive St
Montclair, CA 91763-1639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306850CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Physical Therapy and Wellness Center PC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients

Locations

5350 Olive St
Montclair, CA 91763
Phone (909) 295-5900

Organizations & group practices 1

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": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1104648088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 OLIVE ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 OLIVE ST",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631639",
            "telephone_number": "909-497-1900",
            "fax_number": "909-497-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALATOONZADEH",
        "first_name": "SHAYAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306850",
            "primary": true
        }
    ],
    "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 Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.