Individual provider Active NPI

Marcos Antonios, PT ASSISTANT

Physical Therapy Assistant
Los Angeles, CA

National Provider Identifier

1174175442

Registry record updated Jul 16, 2019

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Los Angeles, CA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Physical Therapy AssistantTaxonomy code 225200000X
License: AT2215 Issued in CA
Practice address: 330 N Hayworth Ave
Los Angeles, CA 90048-2702
Phone: (323) 852-9200
NPI assigned: Jul 16, 2019
Sex: Male
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	AT2215	CA	Primary

Addresses

Primary practice location

330 N Hayworth Ave
Los Angeles, CA 90048-2702

Mailing address

2537 Pacific Coast Hwy Ste D
Torrance, CA 90505-7063
Phone (310) 977-4912

Other practice location 1

2537 Pacific Coast Hwy Ste D
Torrance, CA 90505-7063
Phone (310) 977-4912

Other identifiers 1

Identifier	Type	State	Issuer
A2484669	Other	CA	STATE DRIVERS LICENSE

Electronic endpoints 7

Type	Endpoint	Use
CONNECT URL	TORRANCE
CONNECT URL	TORRANCE
CONNECT URL	TORRANCE
CONNECT URL	TORRANCE	Direct
CONNECT URL	TORRANCE
CONNECT URL	TORRANCE
Direct Messaging Address	marcos.antonios@rehabcare.com	Direct

Medicare participation

Medicare enrollment files

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

National Provider Directory

Medicare enrollment (NPD): Not enrolled

State licenses

License	State	Type	Specialty
AT2215	CA	MD	Physical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1174175442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 PACIFIC COAST HWY STE D",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905057063",
            "telephone_number": "310-977-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N HAYWORTH AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900482702",
            "telephone_number": "323-852-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905057063",
            "country_code": "US",
            "telephone_number": "310-977-4912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONIOS",
        "first_name": "MARCOS",
        "name_prefix": "Mr.",
        "credential": "PT ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT2215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DRIVERS LICENSE",
            "identifier": "A2484669",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TORRANCE",
            "affiliation": "N",
            "endpointDescription": "TORRANCE",
            "address_1": "2537 Pacific Coast Hwy Ste D",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905057063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marcos.antonios@rehabcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "330 N Hayworth Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900482702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 16, 2019; 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.