Makenzie Alyce Heisdorf, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27882 Issued in CA

Practice address

653 Camino de Los Mares Ste 110
San Clemente, CA 92673-2808

Phone

(949) 496-0122

Fax

(949) 496-5027

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Makenzie Osborne Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cowell Health Services IncGroup PAC ID 3971724600, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cowell Health Services, Inc.

  • Physical Therapy Clinic/Center
  • Aliso Viejo, CA
  • NPI 1770994535
  Medicare reassignment Care Compare group NPD
• Rancho Santa Margarita Physical Therapy Sports Medicine Inc

  • Physical Therapy Clinic/Center
  • Rancho Santa Margarita, CA
  • NPI 1477653525
  Medicare reassignment NPD
• Scor Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • San Clemente, CA
  • NPI 1881795375

  Physical Therapist

  Medicare reassignment NPD
• Spearman MD Inc.

  • Vascular & Interventional Radiology Physician
  • Pismo Beach, CA
  • NPI 1508249202
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1104861327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-496-0122",
            "fax_number": "949-496-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 CAMINO DE LOS MARES STE 110",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732808",
            "telephone_number": "949-496-0122",
            "fax_number": "949-496-5027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29803 Santa Margarita Pkwy",
            "address_purpose": "LOCATION",
            "city": "Rancho Santa Margarita",
            "state": "CA",
            "postal_code": "926883609",
            "country_code": "US",
            "telephone_number": "949-459-9010",
            "fax_number": "949-459-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEISDORF",
        "first_name": "MAKENZIE",
        "middle_name": "ALYCE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAKENZIE",
            "last_name": "OSBORNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tanya Lee Hauer, MSW, ACSW
• Pehrson Allen Hawkley, DDS
• Karen G Haycraft, MFT
• Healing Perspective Therapy
• Austin Hedani, PT, DPT
• Ashley Heller, PT
• Madeleine Hendricks
• Henken & Kennedy Orthodontic Dental Group
• Edmond Herbert Henken, DDS, MS
• Ruth Figueira Herdy, NP

• Physical Therapist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.