Individual provider Active NPI

Patrick Magno, DPT

  • Physical Medicine & Rehabilitation Physician
  • Tustin, CA
National Provider Identifier
1225542640
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
294060 Issued in CA
Practice address
14332 Cherrywood LN
Tustin, CA 92780-6946
Phone
(650) 445-2542
NPI assigned
Nov 21, 2017
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 294060 CA Primary

Addresses

Primary practice location

14332 Cherrywood LN
Tustin, CA 92780-6946

Mailing address

14332 Cherrywood LN
Tustin, CA 92780-6946
Phone (650) 445-2542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211000494 CA Practitioner - Physical Therapist in Private Practice 1254699762 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Univ of Calif, Los Angeles School of Dentistry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Tustin, CA 92780
Phone (650) 445-2542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294060CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Activbody Physical Therapy Inc CurrentSince Nov 9, 2021 Accepting new patients
Magno Physical Therapy CurrentSince Jul 8, 2022 Accepting new patients
California Luna Care Physical Therapy PC CurrentSince Sep 8, 2022 Accepting new patients
Mesisca Physical Therapy Inc CurrentSince Jan 31, 2022 Accepting new patients
W. Seth Bolling, MD, Inc PastSince Nov 22, 2017 Accepting new patients
JM Physical Therapy Inc Past Accepting new patients

Locations

19531 Beach Blvd
Huntington Beach, CA 92648
Phone (714) 960-7995

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

1860 N Tustin St
Orange, CA 92865
Phone (714) 998-8403

Organizations & group practices 6

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1225542640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14332 CHERRYWOOD LN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806946",
            "telephone_number": "650-445-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14332 CHERRYWOOD LN",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806946",
            "telephone_number": "650-445-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGNO",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "294060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.