Individual provider Active NPI

Mileva Popovic

  • Physical Therapist
  • Manhattan Beach, CA
National Provider Identifier
1144828179
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1200 Rosecrans Ave Ste 206
Manhattan Beach, CA 90266-2451
Phone
(310) 416-9700
NPI assigned
Oct 12, 2020
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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 NC Primary

Addresses

Primary practice location

1200 Rosecrans Ave Ste 206
Manhattan Beach, CA 90266-2451

Mailing address

3001 Edwards Mill Rd
# 200
Raleigh, NC 27612-5243
Phone (919) 863-6872

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211119002330 NC Practitioner - Physical Therapist in Private Practice 2466841036 Reassigns benefits to 1 organization
I20240807001811 CA Practitioner - Physical Therapist in Private Practice 2466841036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stay Ready IncGroup PAC ID 5395840466, 8 clinicians

Practice addresses (Care Compare)

17323 Ventura Blvd
Suite 100
Encino, CA 91316-3964
Phone (323) 936-7525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Orthopaedic Clinic PA CurrentSince Oct 5, 2021 Accepting new patients
Stay Ready Inc Physical Therapist CurrentSince Jul 1, 2024 Accepting new patients
Raleigh Orthopaedic Pharmacy CurrentSince Oct 31, 2021 Accepting new patients
Advanced Sports Medicine & Orthopedic PT CurrentSince Oct 19, 2020 Accepting new patients
West Coast Sports Physical Therapy, Inc. CurrentSince Oct 19, 2020 Accepting new patients
Body Rehab Center Physical Therapist Past Accepting new patients

Locations

17323 Ventura Blvd
Ste 100
Encino, CA 91316
Phone (323) 936-7525

11701 Wilshire Blvd
Ste 14B1
Los Angeles, CA 90025
Phone (323) 936-7525

5478 Wilshire Blvd
Ste 208
Los Angeles, CA 90036
Phone (323) 936-7525

1200 Rosecrans Ave
Ste 206
Manhattan Beach, CA 90266
Phone (310) 416-9700

1325 Timber Dr E
Garner, NC 27529
Phone (919) 863-6991

3001 Edwards Mill Rd
#200
Raleigh, NC 27612
Phone (919) 863-6853

3001 Edwards Mill Rd
Ste 200
Raleigh, NC 27612
Phone (919) 863-6852

3515 Glenwood Ave
Raleigh, NC 27612
Phone 91978156006856

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1144828179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD",
            "address_2": "# 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-863-6872",
            "fax_number": "919-781-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROSECRANS AVE STE 206",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662451",
            "telephone_number": "310-416-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOVIC",
        "first_name": "MILEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.