Organization Active NPI

Mariners Physical Therapy, Inc.

  • Physical Therapist
  • Santa Ana, CA
National Provider Identifier
1164527305
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARINERS PHYSICAL THERAPY, INC.
Practice address
201 Sandpointe Ave
Suite 130
Santa Ana, CA 92707-5778
Phone
(714) 557-9292
Fax
(714) 557-9137
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Authorized official

Name
Mr. Diane M Morton
Title
Office Manager
Phone
(714) 557-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

201 Sandpointe Ave
Suite 130
Santa Ana, CA 92707-5778

Mailing address

201 Sandpointe Ave
Suite 130
Santa Ana, CA 92707-5778
Phone (714) 557-9292

Other identifiers 1

IdentifierTypeStateIssuer
W14629OtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070124000758 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931100500 Receives reassigned benefits from 11 practitioners
Practice locations: Santa Ana, CA; South Pasadena, CA

National Provider Directory

National Provider Directory

Locations

3200 Bristol St
Ste 180
Costa Mesa, CA 92626
Phone (714) 557-9292

2300 University Dr
Newport Beach, CA 92660

201 Sandpointe Ave
Ste 130
Santa Ana, CA 92707
Phone (714) 557-9292

1015 Hope St
Ste F
South Pasadena, CA 91030
Phone (626) 360-6092

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549238400000",
    "number": "1164527305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SANDPOINTE AVE",
            "address_2": "SUITE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927075778",
            "telephone_number": "714-557-9292",
            "fax_number": "714-557-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SANDPOINTE AVE",
            "address_2": "SUITE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927075778",
            "telephone_number": "714-557-9292",
            "fax_number": "714-557-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINERS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-557-9292",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W14629",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.