Individual provider Active NPI

Bernard H Felipe, PTA

  • Physical Therapy Assistant
  • Torrance, CA
National Provider Identifier
1306496484
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
50224 Issued in CA
Practice address
23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716
Phone
(310) 316-6190
Fax
(310) 540-7362
NPI assigned
Sep 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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 50224 CA Primary

Addresses

Primary practice location

23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716

Mailing address

23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716
Phone (310) 316-6190

Other practice location 1

2200 E Maple Ave
El Segundo, CA 90245-6507
Phone (310) 316-6190

Other identifiers 1

IdentifierTypeStateIssuer
50224OtherCAPHYSICAL THERAPIST ASSISTANT

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

LicenseStateTypeSpecialty
50224CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1306496484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-316-6190",
            "fax_number": "310-540-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-316-6190",
            "fax_number": "310-540-7362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 E Maple Ave",
            "address_purpose": "LOCATION",
            "city": "El Segundo",
            "state": "CA",
            "postal_code": "902456507",
            "country_code": "US",
            "telephone_number": "310-316-6190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELIPE",
        "first_name": "BERNARD",
        "middle_name": "H",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST ASSISTANT",
            "identifier": "50224",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.