Individual provider Active NPI

Surinder P. Brar, P.T.

  • Physical Therapist
  • Aliso Viejo, CA
National Provider Identifier
1255367785
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6659 Issued in CA
Practice address
36 La Mirage Cir
Aliso Viejo, CA 92656-5251
Phone
(949) 349-0911
Fax
(949) 349-9472
NPI assigned
Jun 25, 2006
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6659 CA Primary
Geriatric Physical Therapist 2251G0304X PT6659 CA

Addresses

Primary practice location

36 La Mirage Cir
Aliso Viejo, CA 92656-5251

Mailing address

36 La Mirage Cir
Aliso Viejo, CA 92656-5251
Phone (949) 349-0911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070803000613 CA Practitioner - Physical Therapist in Private Practice 4981795036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Surinder Brar Physical Therapist CurrentSince May 1, 2007 Accepting new patients
Family Medicine Clinic Current Accepting new patients

Locations

100 W 4th St
Walsenburg, CO 81089
Phone (719) 738-1164

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1255367785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 LA MIRAGE CIR",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565251",
            "telephone_number": "949-349-0911",
            "fax_number": "949-349-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 LA MIRAGE CIR",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565251",
            "telephone_number": "949-349-0911",
            "fax_number": "949-349-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAR",
        "first_name": "SURINDER",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6659",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "PT6659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.