Individual provider Active NPI

Niki Mahmoudzadeh, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1174241087
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2650 Camino del Rio N Ste 200
San Diego, CA 92108-1631
Phone
(619) 295-3000
NPI assigned
Aug 16, 2022
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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 NU Primary

Addresses

Primary practice location

2650 Camino del Rio N Ste 200
San Diego, CA 92108-1631

Mailing address

5027 Via Papel
San Diego, CA 92122-3914

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109000676 CA Practitioner - Physical Therapist in Private Practice 0446627186 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

2650 Camino del Rio N
Suite 200
San Diego, CA 92108-1631
Phone (619) 295-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Sep 29, 2022 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Sep 29, 2022 Accepting new patients
Eggleton Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

2650 Camino del Rio N
Ste 200
San Diego, CA 92108
Phone (619) 295-3000

10225 Austin Dr
Ste 204
Spring Valley, CA 91978
Phone (619) 670-4567

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1174241087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027 VIA PAPEL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921223914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 CAMINO DEL RIO N STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081631",
            "telephone_number": "619-295-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOUDZADEH",
        "first_name": "NIKI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.