Individual provider Active NPI

Daria Tavana

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1215453501
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT300229 Issued in CA
Practice address
6080 Center Dr FL 6
Los Angeles, CA 90045-9205
Phone
(888) 859-0145
NPI assigned
Aug 17, 2017
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 40QA01745800 NJ
Physical Therapist 225100000X PT300229 CA Primary

Addresses

Primary practice location

6080 Center Dr FL 6
Los Angeles, CA 90045-9205

Mailing address

PO Box 1295
Venice, CA 90294-1295

Other practice location 1

968 Tabor Rd
Morris Plains, NJ 07950-2734
Phone (973) 829-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222002624 CA Practitioner - Physical Therapist in Private Practice 6406226026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Specialists IncGroup PAC ID 7810071958, 25 clinicians

Practice addresses (Care Compare)

10635 Santa Monica Blvd
Suite 165
Los Angeles, CA 90025-8306
Phone (310) 273-0877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT300229CAMDPhysical Therapist
40QA01745800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adi Rehab, Incorporated Physical Therapist CurrentSince Feb 14, 2024 Accepting new patients
Rehab Specialists, Inc Physical Therapist CurrentSince Feb 14, 2024 Accepting new patients
Kessler Institute for Rehabilitation, Inc. Past Accepting new patients

Locations

5359 Balboa Blvd
Ste A
Encino, CA 91316
Phone (818) 506-7821

2730 Wilshire Blvd
Ste 533
Santa Monica, CA 90403
Phone (310) 273-0870

10635 Santa Monica Blvd
Ste 165
West Los Angeles, CA 90025
Phone 3102730877143

Organizations & group practices 3

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": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1215453501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1295",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902941295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6080 CENTER DR FL 6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900459205",
            "telephone_number": "888-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "968 Tabor Rd",
            "address_purpose": "LOCATION",
            "city": "Morris Plains",
            "state": "NJ",
            "postal_code": "079502734",
            "country_code": "US",
            "telephone_number": "973-829-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVANA",
        "first_name": "DARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01745800",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT300229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.