Active NPI
Debbie Makaena, PTA
- Physical Therapy Assistant
- El Segundo, CA
National Provider Identifier
1265457352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT1948
- Practice address
- 2250 Park PL
El Segundo, CA 90245-4908 - Phone
- (310) 643-9016
- Fax
- (310) 536-0177
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT1948 | CA | Primary |
Addresses
Primary practice location
2250 Park PL
El Segundo, CA 90245-4908
Mailing address
29 Coronado CT
Manhattan Beach, CA 90266-7232
Phone (310) 643-9016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT1948 | CA | MD | Physical Therapy Assistant |
Organizations & group practices 1
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": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265457352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 CORONADO CT",
"city": "MANHATTAN BEACH",
"state": "CA",
"postal_code": "902667232",
"telephone_number": "310-643-9016",
"fax_number": "310-536-0177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 PARK PL",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902454908",
"telephone_number": "310-643-9016",
"fax_number": "310-536-0177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKAENA",
"first_name": "DEBBIE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT1948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.