Individual provider Active NPI

Logan Alexander Siemers, PT, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Irvine, CA
National Provider Identifier
1245055763
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
306509 Issued in CA
Practice address
17241 Murphy Ave
Irvine, CA 92614-5917
Phone
(530) 559-9246
NPI assigned
Nov 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 306509 CA Primary

Addresses

Primary practice location

17241 Murphy Ave
Irvine, CA 92614-5917

Mailing address

18428 Oak Canyon Rd Apt 574
Canyon Country, CA 91387-6358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212001340 CA Practitioner - Physical Therapist in Private Practice 3870029937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

24491 Alicia Pkwy
Mission Viejo, CA 92691-4506
Phone (949) 876-5299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306509CAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther CurrentSince Dec 9, 2024 Accepting new patients
California Rehab & Sports Therapy CurrentSince Dec 9, 2024 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Past Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther Past Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

415 Carmen Dr
Camarillo, CA 93010
Phone (805) 322-9083

255 E Rincon St
Ste 112
Corona, CA 92879
Phone (951) 523-8509

36 Mauchly
Ste A
Irvine, CA 92618
Phone (949) 374-3315

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

24491 Alicia Pkwy
Mission Viejo, CA 92691
Phone (949) 876-5299

19000 Hawthorne Blvd
Ste 300
Torrance, CA 90503
Phone (310) 793-1800

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

Organizations & group practices 5

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": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1245055763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18428 OAK CANYON RD APT 574",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913876358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17241 MURPHY AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145917",
            "telephone_number": "530-559-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMERS",
        "first_name": "LOGAN",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "306509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.