NPIMap

Organization Active NPI

Activbody Physical Therapy Inc

  • Physical Therapist
  • Huntington Beach, CA
National Provider Identifier
1114950557
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13708 Issued in CA
Legal business name
ACTIVBODY PHYSICAL THERAPY INC
Practice address
19531 Beach Blvd
Huntington Beach, CA 92648-2902
Phone
(714) 960-7995
Fax
(714) 960-1884
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Authorized official

Name
Mr. Paul H. Hasenyager, RPTNPI 1063434421
Title
Director/Owner
Phone
(714) 960-7995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT13708 CA Primary

Addresses

Primary practice location

19531 Beach Blvd
Huntington Beach, CA 92648-2902

Mailing address

19531 Beach Blvd
Huntington Beach, CA 92648-2902
Phone (714) 960-7995

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090422000313 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9234286691 Receives reassigned benefits from 2 practitioners
Practice locations: Huntington Beach, CA; Orange, CA

National Provider Directory

National Provider Directory

Locations

19531 Beach Blvd
Huntington Beach, CA 92648
Phone (714) 960-7995

1860 N Tustin St
Orange, CA 92865
Phone (714) 998-8403

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1114950557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19531 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482902",
            "telephone_number": "714-960-7995",
            "fax_number": "714-960-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19531 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926482902",
            "telephone_number": "714-960-7995",
            "fax_number": "714-960-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVBODY PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "HASENYAGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "714-960-7995",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.