Ginelle Vila-Dulay Fajardo, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29347 Issued in CA

Practice address

215 N State College Blvd
Suite G
Anaheim, CA 92806-2932

Phone

(714) 999-6596

Fax

(714) 999-5009

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ginelle Vila Dulay Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State College Physical Therapy Inc.Group PAC ID 2769454388, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• State College Physical Therapy Inc

  • Physical Therapist
  • Anaheim, CA
  • NPI 1689782310
  Medicare reassignment Care Compare group NPD
• State College Physical Therapy

  • Physical Therapist
  • Anaheim, CA
  • NPI 1699780353
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1245338102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 S MIRA CT UNIT 127",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928023532",
            "telephone_number": "714-971-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD",
            "address_2": "SUITE G",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062932",
            "telephone_number": "714-999-6596",
            "fax_number": "714-999-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "GINELLE",
        "middle_name": "VILA-DULAY",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINELLE",
            "last_name": "DULAY",
            "middle_name": "VILA",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Olaniyi Fadeyi, MD
• Fair Care Home Health LLC
• Jessica Lynn Fairbarn, MS
• Huey Lion Fairweather
• Drew Nathan Fajardo
• Jonathan Fajardo
• Manuel Fajardo
• Munna Fakhouri, SLPA
• Alexandra Frediani Fakih, PT, DPT
• Andrew Falahee, PHYSICIAN ASSISTANT

• Physical Therapist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.