Sports Medicine Institute a Professional Physical Therapy Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPORTS MEDICINE INSTITUTE A PROFESSIONAL PHYSICAL THERAPY CORP

Practice address

415 W Taft Ave Ste E
Orange, CA 92865-4249

Phone

(714) 939-6200

Fax

(714) 939-6500

NPI assigned

Jun 1, 2005

Last updated

Oct 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joan M Boesel, DPTNPI 1528060712

Title

Owner President

Phone

(714) 939-6200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Sports Medicine Institute - Los Angeles a Prof Physical Therapy Co

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1093713125

  Member Of

  NPD member

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joan M Boesel, DPT

  • Physical Therapist
  • Orange, CA
  • NPI 1528060712
  Medicare reassignment Care Compare group Authorized official
• Samantha Audrey Richards, PT, DPT, MS

  • Physical Therapist
  • Orange, CA
  • NPI 1073320826
  Medicare reassignment Care Compare group NPD
• Julia Santana, DPT

  • Physical Therapist
  • Orange, CA
  • NPI 1922824655
  Medicare reassignment Care Compare group NPD
• Ashley Rojan, PT, DPT, ATC/L

  • Physical Therapist
  • Louisville, KY
  • NPI 1659742088

  CA

  Medicare reassignment NPD
• Amy E Driscoll, DPT

  • Physical Therapist
  • Anaheim, CA
  • NPI 1215977905
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1144222308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W TAFT AVE STE E",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928654249",
            "telephone_number": "714-939-6200",
            "fax_number": "714-939-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W TAFT AVE STE E",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928654249",
            "telephone_number": "714-939-6200",
            "fax_number": "714-939-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE INSTITUTE A PROFESSIONAL PHYSICAL THERAPY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "BOESEL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "714-939-6200",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abraham Spitzer-Tilchin
• Courtney Spitzer, MD
• Nordy S Spivack, M.D.
• Rebecca Sponberg, NP
• Sports Conditioning and Rehabilitation of California Inc (Star Clinic)
• Kevin Charles Spradlin, LMFT
• Heather Sprague
• Brianna Janine Spratt
• Jean E Sprengel, M.D.
• Crystal Springe, NTP

• Physical Therapist in Orange, CA
• Providers in Orange, CA by specialty
• Physical Therapist in California

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