Individual provider Active NPI

Amit Dinesh Gandhi, PHYSICAL THERAPIST

  • Orthopedic Physical Therapist
  • Costa Mesa, CA
National Provider Identifier
1205017936
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT28231 Issued in CA
Practice address
2790 Harbor Blvd Ste 300
Costa Mesa, CA 92626-5157
Phone
(714) 485-7642
Fax
(714) 427-0785
NPI assigned
Nov 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT28231 CA Primary

Addresses

Primary practice location

2790 Harbor Blvd Ste 300
Costa Mesa, CA 92626-5157

Mailing address

2790 Harbor Blvd Ste 300
Costa Mesa, CA 92626-5157
Phone (714) 485-7642

Other practice location 1

250 El Camino Real Ste 100
Tustin, CA 92780-3655
Phone (714) 485-7642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120403000107 CA Practitioner - Physical Therapist in Private Practice 7810157617 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
HW Physical TherapyGroup PAC ID 8426304825, 3 clinicians
Health Works Physical Therapy IncGroup PAC ID 3274787668, 4 clinicians

Practice addresses (Care Compare)

250 El Camino Real
Suite 100
Tustin, CA 92780-3655
Phone (714) 838-6999

2790 Harbor Blvd
Suite 300
Costa Mesa, CA 92626-5157
Phone (714) 427-0803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28231CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HW Physical Therapy Orthopedic CurrentSince Jun 1, 2018 Accepting new patients
Specialized Physical Therapy, Apc Orthopedic CurrentSince Jun 1, 2018 Accepting new patients
Health Works Physical Therapy, Inc Orthopedic CurrentSince Sep 7, 2012 Accepting new patients
Innovative Wellness Solutions Inc Orthopedic CurrentSince Aug 2, 2011 Accepting new patients

Locations

2951 Harbor Blvd
Costa Mesa, CA 92626
Phone (714) 427-0803

2790 Harbor Blvd
Ste 300
Costa Mesa, CA 92626
Phone (714) 427-0803

250 El Camino Real
Ste 100
Tustin, CA 92780
Phone (714) 485-7642

19768 Yorba Linda Blvd
Yorba Linda, CA 92886
Phone (714) 693-0460

Organizations & group practices 4

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": "1195689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1205017936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HARBOR BLVD STE 300",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265157",
            "telephone_number": "714-485-7642",
            "fax_number": "714-427-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HARBOR BLVD STE 300",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265157",
            "telephone_number": "714-485-7642",
            "fax_number": "714-427-0785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 El Camino Real Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803655",
            "country_code": "US",
            "telephone_number": "714-485-7642",
            "fax_number": "714-838-7099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "AMIT",
        "middle_name": "DINESH",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-22",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT28231",
            "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 Jun 13, 2025; 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.