Individual provider Active NPI

Jayesh Modha

  • Physical Therapy Assistant
  • Norwalk, CA
National Provider Identifier
1295123990
Registry record updated Jan 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
9290 Issued in CA
Practice address
14426 Horst Ave
Norwalk, CA 90650-4956
Phone
(562) 552-6236
NPI assigned
Jan 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 9290 CA Primary

Addresses

Primary practice location

14426 Horst Ave
Norwalk, CA 90650-4956

Mailing address

14426 Horst Ave
Norwalk, CA 90650-4956
Phone (562) 552-6236

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

NPI Registry JSON

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420243200000",
    "number": "1295123990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14426 HORST AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504956",
            "telephone_number": "562-552-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14426 HORST AVE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504956",
            "telephone_number": "562-552-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODHA",
        "first_name": "JAYESH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-03",
        "last_updated": "2015-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "9290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.