Individual provider Active NPI

Andrew Rodriguez, DPT

  • Orthopedic Physical Therapist
  • Pismo Beach, CA
National Provider Identifier
1164998639
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT294879 Issued in CA
Practice address
901 Oak Park Blvd Ste 102
Pismo Beach, CA 93449-3409
Phone
(805) 481-8272
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT294879 CA Primary

Addresses

Primary practice location

901 Oak Park Blvd Ste 102
Pismo Beach, CA 93449-3409

Mailing address

901 Oak Park Blvd Ste 102
Pismo Beach, CA 93449-3409

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
PT294879CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spearman MD Inc. Past Accepting new patients
Moscardi Physical Therapy, Inc Orthopedic PastSince Nov 14, 2012 Accepting new patients

Organizations & group practices 2

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1164998639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 102",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 OAK PARK BLVD STE 102",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493409",
            "telephone_number": "805-481-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ANDREW",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT294879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.