Active NPI
Tyler Cannella
- Physical Therapist
- Dana Point, CA
National Provider Identifier
1235087602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 25411 Sea Bluffs Dr
Dana Point, CA 92629-2190 - Phone
- (949) 541-2232
- NPI assigned
- Mar 20, 2026
- Last updated
- Mar 20, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
25411 Sea Bluffs Dr
Dana Point, CA 92629-2190
Mailing address
2036 County Road 782
Woodland Park, CO 80863-9614
Phone (719) 290-5553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
24441 Calle Sonora
Laguna Woods, CA 92637-7714
Phone (949) 243-5710
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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": "1773964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1235087602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2036 COUNTY ROAD 782",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "808639614",
"telephone_number": "719-290-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25411 SEA BLUFFS DR",
"city": "DANA POINT",
"state": "CA",
"postal_code": "926292190",
"telephone_number": "949-541-2232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNELLA",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-20",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dana Point, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.