Individual provider Active NPI

Zachary Shampain, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1316545684
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
046232 Issued in NY
Practice address
2495 Truxtun Rd Ste 200
San Diego, CA 92106-6159
Phone
(858) 755-5200
Fax
(619) 223-2307
NPI assigned
Oct 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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 046232 NY Primary

Addresses

Primary practice location

2495 Truxtun Rd Ste 200
San Diego, CA 92106-6159

Mailing address

307 5TH Ave FL 6
New York, NY 10016-6575
Phone (212) 759-2282

Other practice location 1

269 W 16th St
New York, NY 10011-6000
Phone (646) 841-1411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230131001704 CA Practitioner - Physical Therapist in Private Practice 7719397017 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046232NYMDPhysical Therapist

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
Paul J Marsh Chiropractic Corporation Past Accepting new patients
Ortega Chiropractic, Inc. PastSince Jun 14, 2017 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1316545684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 5TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166575",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 TRUXTUN RD STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921066159",
            "telephone_number": "858-755-5200",
            "fax_number": "619-223-2307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 W 16th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100116000",
            "country_code": "US",
            "telephone_number": "646-841-1411",
            "fax_number": "212-379-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMPAIN",
        "first_name": "ZACHARY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-09",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "046232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.