Individual provider Active NPI

Ann-Marie Wurzbach, PT

  • Physical Therapist
  • El Centro, CA
National Provider Identifier
1194727222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 13114 Issued in CA
Practice address
428 N Imperial Ave
El Centro, CA 92243-2329
Phone
(760) 353-3422
Fax
(760) 353-9163
NPI assigned
Jun 1, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT 13114 CA Primary

Addresses

Primary practice location

428 N Imperial Ave
El Centro, CA 92243-2329

Mailing address

1985 Chambers LN
Holtville, CA 92250-9533
Phone (760) 356-1150

Other identifiers 1

IdentifierTypeStateIssuer
OPT131140OtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040417000629 CA Practitioner - Physical Therapist in Private Practice 8729073804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Farid Zia Physical Therapist a Professional CorpGroup PAC ID 5193613289, 4 clinicians

Practice addresses (Care Compare)

1698 Cruickshank Dr
Suite a
El Centro, CA 92243-1462
Phone (760) 353-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 13114CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Farid Zia Physical Therapist a Professional Corp Physical Therapist CurrentSince Mar 13, 2007 Accepting new patients

Locations

420 Heffernan Ave
Ste 2B
Calexico, CA 92231
Phone (760) 355-7929

1698 Cruickshank Dr
Ste A
El Centro, CA 92243
Phone (760) 353-3422

428 N Imperial Ave
El Centro, CA 92243
Phone (760) 353-3422

Organizations & group practices 1

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194727222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 CHAMBERS LN",
            "city": "HOLTVILLE",
            "state": "CA",
            "postal_code": "922509533",
            "telephone_number": "760-356-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432329",
            "telephone_number": "760-353-3422",
            "fax_number": "760-353-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURZBACH",
        "first_name": "ANN-MARIE",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 13114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPT131140",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.