Talia Gordon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

302588 Issued in CA

Practice address

3959 Ruffin Rd Ste J
San Diego, CA 92123-1830

Phone

(858) 279-5570

NPI assigned

Mar 15, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab United Sports Medicine and Physical Therapy, Inc.Group PAC ID 0446157226, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Physical Therapist
  • San Diego, CA
  • NPI 1134216294
  Medicare reassignment Care Compare group NPD
• Rehab United Sports Medicine & Physical Therapy, Inc.

  • Customized Equipment (DME)
  • Escondido, CA
  • NPI 1891581971
  NPD

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1275392987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 RUFFIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231830",
            "telephone_number": "858-279-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 RUFFIN RD STE J",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231830",
            "telephone_number": "858-279-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "TALIA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "302588",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Margaret Gordon, LCSW
• Richard L Gordon, PHARM. D.
• Robert Gordon, BCBA
• Ryan James Gordon, SFIDC
• Susan G. Gordon, LCSW
• Taylor Gordon
• Thomas William Gordon, IDC
• Trinity Gordon
• Zachary M. Gordon, M.D.
• Jill Shannon Gordy-Moody, LCSW

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.