Physiotherapy Associates, Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

PHYSIOTHERAPY ASSOCIATES, INC.

Practice address

15525 Pomerado Rd Ste C8
Poway, CA 92064-2426

Phone

(717) 972-1100

NPI assigned

Oct 14, 2020

Organization subpart

Yes

Parent organization

SELECT MEDICALAs reported in NPPES

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

Authorized official

Name

Michael Tarvin

Title

Vice President

Phone

(717) 972-1100

Specialties & licenses 2

Addresses

Part of

Select Medical Corporation

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1134727951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE C8",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642426",
            "telephone_number": "717-972-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOTHERAPY ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Pham
• Philip Wrotslavsky, DPM, a Professional Corporation
• Julien Philippe
• Mikayla Phillips
• Tatyanna Phillips
• Lauren Elisabeth Pichard, PSY.D.
• Susan L. Pietrzyk, P.T.
• Pimg, a Professional Medical Corporation
• Pimg; a Professional Medical Corporation
• Richard Pina

• Rehabilitation Clinic/Center in Poway, CA
• Providers in Poway, CA by specialty
• Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.