Eleazar Somintac Tayag, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

33402 Issued in CA

Practice address

12381 Bali St
Victorville, CA 92392-6825

Phone

(909) 509-6064

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imperial Physical Therapy P CGroup PAC ID 8921520016, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Caring Shield Hospice Inc

  • Community Based Hospice Care Agency
  • Riverside, CA
  • NPI 1932502945

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Paramount Professionals Inc

  • Home Health Agency
  • Victorville, CA
  • NPI 1104067578

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership

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.

• Imperial Physical Therapy P C

  • Physical Therapist
  • Victorville, CA
  • NPI 1326890385
  Medicare reassignment Care Compare group NPD Authorized official
• Optimum Care Provider, Inc.

  • Physical Therapist
  • Victorville, CA
  • NPI 1114211885
  NPD Authorized official
• Caring Shield Hospice Inc

  • Community Based Hospice Care Agency
  • Riverside, CA
  • NPI 1932502945
  NPD
• Paramount Professionals Inc

  • Home Health Agency
  • Victorville, CA
  • NPI 1104067578
  NPD

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697328000000",
    "number": "1245355783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10245 BIG CHIEF DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926869",
            "telephone_number": "909-509-6064",
            "fax_number": "760-983-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 BALI ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923926825",
            "telephone_number": "909-509-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYAG",
        "first_name": "ELEAZAR",
        "middle_name": "SOMINTAC",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-10-15",
        "certification_date": "2023-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Tapia
• Phillip George Tardanico, LCSW 69611
• Amanda Marie Tarwater
• Julia Tashima, A.T.,C
• Terri Ramona Tauqir, PSYD
• Erdemar Tayag, PT
• Imani Taylor
• Mechelle Taylor
• Team Therapy and Rehabilitation, Inc
• Danyll Teel

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.