Individual provider Active NPI

Nikita Desai, PT, DPT

  • Physical Therapist
  • Foothill Ranch, CA
National Provider Identifier
1285085944
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
291498 Issued in CA
Practice address
26672 Portola Pkwy Ste 116
Foothill Ranch, CA 92610-1773
Phone
(800) 788-5753
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 291498 CA Primary

Addresses

Primary practice location

26672 Portola Pkwy Ste 116
Foothill Ranch, CA 92610-1773

Mailing address

19 Las Balas
Rancho Santa Margarita, CA 92688-4124
Phone (213) 675-0244

Other practice location 1

2492 Walnut Ave
# 140
Tustin, CA 92780-6953
Phone (714) 544-2188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919000492 CA Practitioner - Physical Therapist in Private Practice 7719274877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prosport Physical Therapy Professionals IncGroup PAC ID 0749510634, 93 clinicians

Practice addresses (Care Compare)

2777 Bristol St
Suite B
Costa Mesa, CA 92626-5997
Phone (949) 250-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Aug 22, 2022 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Aug 22, 2022 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist Current Accepting new patients

Locations

2777 Bristol St
Ste B
Costa Mesa, CA 92626
Phone (949) 250-1112

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1285085944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LAS BALAS",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926884124",
            "telephone_number": "213-675-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26672 PORTOLA PKWY STE 116",
            "city": "FOOTHILL RANCH",
            "state": "CA",
            "postal_code": "926101773",
            "telephone_number": "800-788-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2492 Walnut Ave",
            "address_2": "# 140",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806953",
            "country_code": "US",
            "telephone_number": "714-544-2188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESAI",
        "first_name": "NIKITA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foothill Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.