NPIMap

Organization Active NPI

Evolution Physical Therapy, Inc

  • Physical Therapist
  • Culver City, CA
National Provider Identifier
1174601116
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26595 Issued in CA
Legal business name
EVOLUTION PHYSICAL THERAPY, INC
Practice address
11825 Major St
Penthouse Suite
Culver City, CA 90230-6356
Phone
(310) 915-6100
Fax
(310) 915-0100
NPI assigned
Nov 1, 2006
Last updated
Oct 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Michael Giunta, DPTNPI 1386942951
Title
Owner/Ceo
Phone
(310) 915-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT34146 CA
Physical Therapist 225100000X PT30287 CA
Physical Therapist 225100000X PT35833 CA
Physical Therapist 225100000X PT28561 CA
Physical Therapist 225100000X PT37632 CA
Physical Therapist 225100000X PT37934 CA
Physical Therapist 225100000X 39128 CA
Physical Therapist 225100000X PT26595 CA Primary

Addresses

Primary practice location

11825 Major St
Penthouse Suite
Culver City, CA 90230-6356

Mailing address

322 Culver Blvd
#217
Playa del Rey, CA 90293-7704
Phone (310) 915-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070426000134 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0244336964 Receives reassigned benefits from 104 practitioners
Practice locations: Beverly Hills, CA; Westlake Village, CA; Santa Monica, CA; Manhattan Beach, CA; Los Angeles, CA; Irvine, CA; Hawthorne, CA; Culver City, CA…

National Provider Directory

National Provider Directory
Tax ID family
Bebe PT2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

201 N Robertson Blvd
Ste 101
Beverly Hills, CA 90211
Phone (424) 303-7647

850 W 18th St
Ste D
Costa Mesa, CA 92627
Phone (424) 297-3600

11825 Major St
Ph
Culver City, CA 90230
Phone (310) 915-6100

6826 S Centinela Ave
Culver City, CA 90230
Phone (310) 915-6100

12703 Cerise Ave
Hawthorne, CA 90250
Phone (424) 297-3600

17751 Sky Park Cir
Ste C
Irvine, CA 92614
Phone (424) 297-3833

888 Ridge Vly
Irvine, CA 92618
Phone (949) 774-1600

11600 Wilshire Blvd
Ste 199
Los Angeles, CA 90025
Phone (424) 248-0100

131 N La Brea Ave
Los Angeles, CA 90036
Phone (315) 562-1650

6086 Comey Ave
Los Angeles, CA 90034
Phone (310) 915-6100

500 S Sepulveda Blvd
Ste 106
Manhattan Beach, CA 90266
Phone (310) 644-9515

2425 Colorado Ave
Ste 100
Santa Monica, CA 90404
Phone (310) 829-2420

925 Wilshire Blvd
Santa Monica, CA 90401
Phone (310) 319-0090

925 Wilshire Blvd
Ste A
Santa Monica, CA 90401
Phone (310) 319-0090

Practitioners & affiliated clinicians

Practitioners 133

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 133

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1174601116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 CULVER BLVD",
            "address_2": "#217",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937704",
            "telephone_number": "310-915-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11825 MAJOR ST",
            "address_2": "PENTHOUSE SUITE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306356",
            "telephone_number": "310-915-6100",
            "fax_number": "310-915-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "GIUNTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "310-915-6100",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34146",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30287",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT35833",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28561",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37632",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37934",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39128",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.