Individual provider Active NPI

Tamanna Rohan Mahadik, PT

  • Physical Therapist
  • Costa Mesa, CA
National Provider Identifier
1174809057
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301951 Issued in CA
Practice address
1520 Nutmeg PL Ste 111
Costa Mesa, CA 92626-2557
Phone
(714) 979-3500
NPI assigned
Oct 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 033803 NY
Physical Therapist 225100000X 301951 CA Primary

Addresses

Primary practice location

1520 Nutmeg PL Ste 111
Costa Mesa, CA 92626-2557

Mailing address

1520 Nutmeg PL Ste 111
Costa Mesa, CA 92626-2557
Phone (714) 979-3500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221005001955 CA Practitioner - Physical Therapist in Private Practice 7911170048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select CS Physical Therapy PCGroup PAC ID 1355742081, 177 clinicians

Practice addresses (Care Compare)

1310 W Stewart Dr
Suite 404
Orange, CA 92868-3855
Phone (714) 707-6466

18800 Delaware St
Suite 350
Huntington Beach, CA 92648-6084
Phone (714) 848-8318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301951CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select CS Physical Therapy, P.C. Physical Therapist Current Accepting new patients
Select Cal Physical Therapy PC Physical Therapist Current Accepting new patients
Select Cal Physical Therapy PC Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Mar 1, 2023 Accepting new patients
Select CS Physical Therapy, P.C. CurrentSince Mar 1, 2023 Accepting new patients
Select Cal Physical Therapy PC CurrentSince Nov 1, 2022 Accepting new patients
R.G. Medical, PC PastSince Oct 10, 2011 Accepting new patients

Locations

1520 Nutmeg Pl
Ste 111
Costa Mesa, CA 92626
Phone (714) 979-3500

10540 Talbert Ave
Ste 250W
Fountain Vly, CA 92708
Phone (714) 964-0727

360 Dardanelli Ln
Ste 1F
Los Gatos, CA 95032
Phone (408) 374-8823

929 Pacific St
Monterey, CA 93940
Phone (831) 373-1209

1310 W Stewart Dr
Ste 404
Orange, CA 92868
Phone (714) 707-6466

268 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 591-9581

Organizations & group practices 7

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": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1174809057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL STE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262557",
            "telephone_number": "714-979-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 NUTMEG PL STE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262557",
            "telephone_number": "714-979-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHADIK",
        "first_name": "TAMANNA",
        "middle_name": "ROHAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033803",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.