Organization Active NPI

Orthopaedic and Sports Physical Therapy

  • Physical Therapist
  • Irvine, CA
National Provider Identifier
1245632546
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT36457 Issued in CA
Legal business name
ORTHOPAEDIC AND SPORTS PHYSICAL THERAPY
Practice address
19742 Macarthur Blvd Ste 110
Irvine, CA 92612-2408
Phone
(949) 825-6928
Fax
(949) 825-6948
NPI assigned
Sep 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

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

Authorized official

Name
Dr. Andy Kasimatis, DPTNPI 1932427390
Title
Owner
Phone
(508) 331-8838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT36457 CA Primary

Addresses

Primary practice location

19742 Macarthur Blvd Ste 110
Irvine, CA 92612-2408

Mailing address

PO Box 4877
Laguna Beach, CA 92652-4877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141006001987 CA Part B Supplier - Clinic/Group Practice 3779703103 Receives reassigned benefits from 1 practitioner
Practice locations: Irvine, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415664000000",
    "number": "1245632546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4877",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926524877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122408",
            "telephone_number": "949-825-6928",
            "fax_number": "949-825-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC AND SPORTS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-11-11",
        "status": "A",
        "authorized_official_last_name": "KASIMATIS",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-331-8838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT36457",
            "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 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.