Individual provider Active NPI

Sara Sogol Amoli, MPT, CSCS

  • Orthopedic Physical Therapist
  • Irvine, CA
National Provider Identifier
1306934856
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
26792 Issued in CA
Practice address
1124 Main St
Suite C
Irvine, CA 92614-6760
Phone
(949) 394-8768
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 26792 CA Primary

Addresses

Primary practice location

1124 Main St
Suite C
Irvine, CA 92614-6760

Mailing address

1422 Keel Dr
Corona del Mar, CA 92625-1239
Phone (949) 394-8768

Other identifiers 1

IdentifierTypeStateIssuer
26792OtherCAPHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000659 CA Practitioner - Physical Therapist in Private Practice 9830282276 Practice locations: Irvine, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1124 Main St C
Irvine, CA 92614-6758
Phone (949) 679-7755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26792CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proedge Physical Therapy Orthopedic PastSince Jan 1, 1990 Accepting new patients
The Sportsmed Company Past Accepting new patients

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1306934856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 KEEL DR",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251239",
            "telephone_number": "949-394-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 MAIN ST",
            "address_2": "SUITE C",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146760",
            "telephone_number": "949-394-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOLI",
        "first_name": "SARA",
        "middle_name": "SOGOL",
        "credential": "MPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "26792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "26792",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.