Individual provider Active NPI

Maura Suriba Rey, PT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1154633923
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 27821 Issued in CA
Practice address
2010 Wilshire Blvd Ste 404
Los Angeles, CA 90057-3598
Phone
(213) 353-0003
Fax
(213) 353-0004
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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 27821 CA Primary

Addresses

Primary practice location

2010 Wilshire Blvd Ste 404
Los Angeles, CA 90057-3598

Mailing address

1224 E Glenoaks Blvd Apt 6
Glendale, CA 91206-2543
Phone (818) 571-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT 27821CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soft Physical Therapy Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1154633923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 E GLENOAKS BLVD APT 6",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062543",
            "telephone_number": "818-571-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 WILSHIRE BLVD STE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573598",
            "telephone_number": "213-353-0003",
            "fax_number": "213-353-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REY",
        "first_name": "MAURA",
        "middle_name": "SURIBA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 27821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.