Individual provider Active NPI

Sara Marie Jacobs, PT

  • Physical Therapist
  • Arcadia, CA
National Provider Identifier
1235167552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29526 Issued in CA
Practice address
440 E Huntington Dr
Suite 104
Arcadia, CA 91006-3776
Phone
(626) 445-4222
Fax
(626) 445-4350
NPI assigned
Jun 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PT29526 CA Primary

Addresses

Primary practice location

440 E Huntington Dr
Suite 104
Arcadia, CA 91006-3776

Mailing address

119 Malvern Ave
Fullerton, CA 92832-1405
Phone (626) 806-1165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824001386 CA Practitioner - Physical Therapist in Private Practice 0143294181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Body Center Physical Therapy, IncGroup PAC ID 4880799873, 5 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

224 N Indian Hill Blvd
Claremont, CA 91711-4609
Phone (909) 621-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29526CAMDPharmacist
PT29526CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body Center Physical Therapy, Inc Physical Therapist CurrentSince Dec 1, 2009 Accepting new patients
Bodybasics Physical Therapy, Inc. CurrentSince Jan 7, 2008 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Feb 8, 2024 Accepting new patients
Bodybasics Physical Therapy, Inc. PastSince Jan 7, 2008 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients

Locations

224 N Indian Hill Blvd
Claremont, CA 91711
Phone (909) 621-0447

2275 S Main St
Ste 102
Corona, CA 92882
Phone (951) 273-7742

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

3179 Hamner Ave
Ste 7
Norco, CA 92860
Phone (951) 736-5646

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235167552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 MALVERN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321405",
            "telephone_number": "626-806-1165",
            "fax_number": "626-445-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E HUNTINGTON DR",
            "address_2": "SUITE 104",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063776",
            "telephone_number": "626-445-4222",
            "fax_number": "626-445-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "SARA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.