Individual provider Active NPI

Roxanne Shaw, PT, DPT

  • Physical Therapist
  • Reseda, CA
National Provider Identifier
1316620396
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304531 Issued in CA
Practice address
18039 Sherman Way
Reseda, CA 91335-4630
Phone
(818) 343-4303
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 304531 CA Primary

Addresses

Primary practice location

18039 Sherman Way
Reseda, CA 91335-4630

Mailing address

25115 Avenue Stanford Ste B135
Valencia, CA 91355-1290
Phone (661) 250-9940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017001624 CA Practitioner - Physical Therapist in Private Practice 1850746496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Vargo Physical Therapy, Inc.Group PAC ID 4486639143, 30 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

3425 W Victory Blvd
Burbank, CA 91505-1545
Phone (661) 947-9977

Merit-based Incentive Payment System (MIPS)

Final score
61.07 of 100Reported as group
Quality
51.37
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304531CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vargo Physical Therapy, Inc. Physical Therapist CurrentSince Oct 1, 2023 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jun 13, 2024 Accepting new patients
Vargo Physical Therapy, Inc Physical Therapist PastSince Oct 1, 2023 Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

3425 W Victory Blvd
Burbank, CA 91505
Phone (818) 955-8855

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

11225 Tampa Ave
Porter Ranch, CA 91326
Phone (818) 363-9970

18039 Sherman Way
Reseda, CA 91335
Phone (818) 708-8100

25115 Avenue Stanford
Ste B135
Valencia, CA 91355
Phone (661) 250-9940

25115 Avenue Stanford
#B135
Valencia, CA 91355

7320 Woodlake Ave
Ste 140
West Hills, CA 91307
Phone (818) 638-9639

Organizations & group practices 4

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": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1316620396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25115 AVENUE STANFORD STE B135",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913551290",
            "telephone_number": "661-250-9940",
            "fax_number": "991-250-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18039 SHERMAN WAY",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354630",
            "telephone_number": "818-343-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ROXANNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reseda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.