Individual provider Active NPI

Alexander Christian Victoria, DPT

  • Physical Therapist
  • Goleta, CA
National Provider Identifier
1306440938
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299531 Issued in CA
Practice address
5385 Hollister Ave
Goleta, CA 93111-2389
Phone
(805) 681-7781
Fax
(805) 682-5379
NPI assigned
Nov 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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 299531 CA Primary

Addresses

Primary practice location

5385 Hollister Ave
Goleta, CA 93111-2389

Mailing address

5385 Hollister Ave
Goleta, CA 93111-2389
Phone (805) 681-7781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203002790 CA Practitioner - Physical Therapist in Private Practice 5496169310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

5385 Hollister Ave
BLDG 1
Santa Barbara, CA 93111-2389
Phone (805) 681-7781

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299531CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Jan 4, 2021 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Jan 4, 2021 Accepting new patients
Sansum Clinic PastSince Nov 29, 2020 Accepting new patients
Santa Barbara Cottage Hospital PastSince Nov 29, 2020 Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

5385 Hollister Ave
Bldg 1
Santa Barbara, CA 93111
Phone (805) 681-7781

Interoperability endpoints

  • Direct secure messaging: avictoria759815@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1306440938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5385 HOLLISTER AVE",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931112389",
            "telephone_number": "805-681-7781",
            "fax_number": "805-682-5379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5385 HOLLISTER AVE",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931112389",
            "telephone_number": "805-681-7781",
            "fax_number": "805-682-5379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "ALEXANDER",
        "middle_name": "CHRISTIAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goleta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.