Individual provider Active NPI

Natasha Tininenko, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1225170087
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3703 Camino del Rio S
Ste. 100a
San Diego, CA 92108-4031
Phone
(619) 269-2336
Fax
(619) 269-7608
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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 IL Primary

Addresses

Primary practice location

3703 Camino del Rio S
Ste. 100a
San Diego, CA 92108-4031

Mailing address

3070 Madison St
Carlsbad, CA 92008-2310
Phone (760) 591-7750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314004210 AZ Practitioner - Physical Therapist in Private Practice 0345327102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Physical Therapy IncGroup PAC ID 3173624616, 5 clinicians

Practice addresses (Care Compare)

20325 N 51St Ave
B6 Suite 148
Glendale, AZ 85308-4610
Phone (623) 249-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34024CAMDProsthodontist
070013871ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Jean Boutelle Carlsbad Physical Therapy Physical Therapist Past Accepting new patients
Vascular Surgery NW PS Past Accepting new patients
East Valley Physical Therapy & Aquatic Rehabilitation LTD Physical Therapist PastSince Nov 1, 1999 Accepting new patients
Performance Physical Therapy, LLC Physical Therapist Past Accepting new patients
Scott J. Miscovich MD, LLC PastSince Apr 20, 2003 Accepting new patients
Action Rehab Inc Physical Therapist PastSince Aug 2, 2010 Accepting new patients

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1225170087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MADISON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082310",
            "telephone_number": "760-591-7750",
            "fax_number": "760-294-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 CAMINO DEL RIO S",
            "address_2": "STE. 100A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084031",
            "telephone_number": "619-269-2336",
            "fax_number": "619-269-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TININENKO",
        "first_name": "NATASHA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.