Luis Avelino

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA49322 Issued in CA

Practice address

875 El Cajon Blvd
El Cajon, CA 92020-5714

Phone

(619) 205-4585

NPI assigned

Feb 17, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1194423368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 E DIVISION ST SPC B9",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919501633",
            "telephone_number": "619-708-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 EL CAJON BLVD",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205714",
            "telephone_number": "619-205-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELINO",
        "first_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PTA49322",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA49322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.