Individual provider Active NPI

Jaime Elizabeth-Lyn Ross, DPT

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1124005665
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 32123 Issued in CA
Practice address
510 Hacienda Dr
Suite 107
Vista, CA 92081-6637
Phone
(760) 630-0683
Fax
(760) 630-7715
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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 PT 32123 CA Primary

Addresses

Primary practice location

510 Hacienda Dr
Suite 107
Vista, CA 92081-6637

Mailing address

7525 Jerez CT
Unit Ah
Carlsbad, CA 92009-7443
Phone (213) 268-3188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050915000981 CA Practitioner - Physical Therapist in Private Practice 2769415165 Practice locations: Vista, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

510 Hacienda Dr
Suite 107
Vista, CA 92081-6639
Phone (213) 268-3188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32123CAMDPharmacotherapy Pharmacist
PT 32123CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Rehabilitation Medicine Associates Physical Therapist Past Accepting new patients

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1124005665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 JEREZ CT",
            "address_2": "UNIT AH",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920097443",
            "telephone_number": "213-268-3188",
            "fax_number": "760-630-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HACIENDA DR",
            "address_2": "SUITE 107",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816637",
            "telephone_number": "760-630-0683",
            "fax_number": "760-630-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JAIME",
        "middle_name": "ELIZABETH-LYN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 32123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.