Ageless Physical Therapy PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

AGELESS PHYSICAL THERAPY PC

Practice address

1600 W Coast Hwy Ste G
Newport Beach, CA 92663-5000

Phone

(949) 272-3325

Fax

(949) 333-2962

NPI assigned

Apr 13, 2023

Organization subpart

No

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

Authorized official

Name

Nader Theodory, PTNPI 1538657788

Title

Owner

Phone

(714) 944-3289

Specialties & licenses 1

Addresses

Other names 1

• FOREVER YOUNG THERAPY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Nader Theodory, PT

  • Physical Therapist
  • Newport Beach, CA
  • NPI 1538657788
  Medicare reassignment NPD Authorized official
• George Siegel, M.A.

  • Occupational Therapist
  • Newport Beach, CA
  • NPI 1316926462
  Medicare reassignment
• Paige Lauren Stephens, PT, DPT

  • Physical Therapist
  • Huntington Beach, CA
  • NPI 1699381517

  Physical Medicine & Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723939200000",
    "number": "1245926187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W COAST HWY STE G",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635000",
            "telephone_number": "949-272-3325",
            "fax_number": "949-333-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W COAST HWY STE G",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635000",
            "telephone_number": "949-272-3325",
            "fax_number": "949-333-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A",
        "authorized_official_last_name": "THEODORY",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-944-3289",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOREVER YOUNG THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FOREVER YOUNG THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ae Care Support
• Affinity Group, LLC.
• Kamran Aflatoon, D.O.
• Afsaneh K Alisobhani, PSYD, a Marriage and Family Therapy Professional
• Olutimmi A. Agbelemose, PSY.D.
• Kajal Kiran Aggarwal, ACSW 112943
• Elda Aghaian, M.D.
• Deanna Aghbashian
• Richard Courtney Agnew, MD OB GYN
• Samantha S Agricola

• Physical Medicine & Rehabilitation Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.