Individual provider Active NPI

Taisa Skovorodko, DPT

  • Physical Therapist
  • Santa Barbara, CA
National Provider Identifier
1124316062
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 37490 Issued in CA
Practice address
2320 Calle Real
Santa Barbara, CA 93105-4231
Phone
(805) 687-8553
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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 37490 CA Primary

Addresses

Primary practice location

2320 Calle Real
Santa Barbara, CA 93105-4231

Mailing address

2320 Calle Real
Santa Barbara, CA 93105-4231

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615002492 CA Practitioner - Physical Therapist in Private Practice 7416268669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

470 S Patterson Ave
Santa Barbara, CA 93111-2404

5385 Hollister Ave
BLDG 1
Santa Barbara, CA 93111-2389
Phone (805) 681-7781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 37490CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Apr 6, 2015 Accepting new patients
Sansum Clinic CurrentSince Apr 6, 2015 Accepting new patients
Sansum Clinic Current Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients
Santa Barbara Comprehensive Outpatient Rehabilitation Facility Physical Therapist PastSince Jan 1, 2023 Accepting new patients
Sansum Clinic Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

4151 Foothill Rd
Santa Barbara, CA 93110
Phone (805) 681-1760

Organizations & group practices 6

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1124316062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 CALLE REAL",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 CALLE REAL",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054231",
            "telephone_number": "805-687-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVORODKO",
        "first_name": "TAISA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 37490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.