Individual provider Active NPI

Christopher S Ambrose, M.P.T.

  • Physical Therapist
  • San Marcos, CA
National Provider Identifier
1114977535
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26311 Issued in CA
Practice address
935 W San Marcos Blvd
Ste 102
San Marcos, CA 92078-1142
Phone
(760) 471-2440
Fax
(760) 471-2442
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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 26311 CA Primary

Addresses

Primary practice location

935 W San Marcos Blvd
Ste 102
San Marcos, CA 92078-1142

Mailing address

3070 Madison St
Carlsbad, CA 92008-2310
Phone (760) 591-7750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040731000169 CA Practitioner - Physical Therapist in Private Practice 2769452135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment
Group practices
Barbara Jean Boutelle Carlsbad Physical TherapyGroup PAC ID 4082527189, 15 clinicians

Practice addresses (Care Compare)

2067 W Vista Way
185 Tri City Physical Therapy
Vista, CA 92083-6033
Phone (760) 631-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26311CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist Current Accepting new patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist CurrentSince Aug 24, 2010 Accepting new patients
Barbara Jean Boutelle/Carlsbad Physical Therapy Physical Therapist CurrentSince Aug 24, 2010 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

467 College Blvd
Ste 6
Oceanside, CA 92057
Phone (760) 295-5156

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

9909 Mira Mesa Blvd
Ste 120
San Diego, CA 92131
Phone (858) 693-0436

6195 Cornerstone Ct E
Ste 101
San Diego, CA 92121
Phone (858) 230-6044

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1114977535",
    "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": "760-591-7750",
            "fax_number": "760-294-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 W SAN MARCOS BLVD",
            "address_2": "STE 102",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781142",
            "telephone_number": "760-471-2440",
            "fax_number": "760-471-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "26311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.