Taylor Verissimo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

305756 Issued in CA

Practice address

600 Palm Ave Ste 126
Imperial Beach, CA 91932-1246

Phone

(209) 552-1181

NPI assigned

Apr 8, 2024

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Performance Plus Physical Therapy, Inc.

  • Physical Therapist
  • Chula Vista, CA
  • NPI 1144766064
  Medicare reassignment NPD
• The Chiro Office

  • Chiropractor
  • Chula Vista, CA
  • NPI 1245566959
  NPD (past)

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1124871629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PALM AVE STE 126",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321246",
            "telephone_number": "209-552-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PALM AVE STE 126",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321246",
            "telephone_number": "209-552-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERISSIMO",
        "first_name": "TAYLOR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaysa Thygersen, FNP-BC
• Tamara Lila Trily, DPT
• Lora Jane Urig, D.C.
• Ida Chen Van Houten, RN
• Marianela Vasquez-Sosa, PHARMACIST
• Giovanni Xavier Villanueva, DPT
• VN Healthy Living Medical Group Inc
• Adia Adriana Warren
• Janelle Way
• Audrey Lee Weiss, OD

• Physical Therapist in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.