Individual provider Active NPI

Bernard Budnik, P.T.

  • Physical Therapist
  • Thousand Oaks, CA
National Provider Identifier
1174549885
Registry record updated May 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18445 Issued in CA
Practice address
110 Jensen CT
Suite 2C
Thousand Oaks, CA 91360-7483
Phone
(805) 413-1070
Fax
(805) 413-1076
NPI assigned
Jul 14, 2006
Last updated
May 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2008

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 18445 CA Primary

Addresses

Primary practice location

110 Jensen CT
Suite 2C
Thousand Oaks, CA 91360-7483

Mailing address

1220 La Venta Dr
Suite 102
Westlake Village, CA 91361-3703
Phone (805) 777-7370

Other identifiers 3

IdentifierTypeStateIssuer
18445OtherCAPT LICENSE
1558498337OtherCATO GROUP NPI #
1043236078OtherCAWLV GROUP NPI #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000598 CA Practitioner - Physical Therapist in Private Practice 0446151948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Physical Therapy, Inc.Group PAC ID 5991606493, 4 clinicians

Practice addresses (Care Compare)

110 Jensen CT
Suite 2C
Thousand Oaks, CA 91360-7485
Phone (805) 413-1070

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Physical Therapy, Inc. Physical Therapist CurrentSince Jan 1, 2002 Accepting new patients
Westlake Physical Therapy, Inc. Physical Therapist PastSince Jan 1, 2002 Accepting new patients

Locations

110 Jensen Ct
Ste 2C
Thousand Oaks, CA 91360
Phone (805) 413-1070

1220 La Venta Dr
Ste 102
Westlake Vlg, CA 91361
Phone (805) 777-7370

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, 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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210982400000",
    "number": "1174549885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE 102",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-777-7370",
            "fax_number": "805-777-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 JENSEN CT",
            "address_2": "SUITE 2C",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913607483",
            "telephone_number": "805-413-1070",
            "fax_number": "805-413-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDNIK",
        "first_name": "BERNARD",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2008-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "18445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "18445",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TO GROUP NPI #",
            "identifier": "1558498337",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WLV GROUP NPI #",
            "identifier": "1043236078",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2008; 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.