Individual provider Active NPI

Rydell Simpauco

  • Physical Therapist
  • Chula Vista, CA
National Provider Identifier
1316681158
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT301881 Issued in CA
Practice address
910 Hale PL Ste 115
Chula Vista, CA 91914-3504
Phone
(619) 369-2667
NPI assigned
Apr 27, 2022
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 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 PT301881 CA Primary

Addresses

Primary practice location

910 Hale PL Ste 115
Chula Vista, CA 91914-3504

Mailing address

3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (888) 208-8526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220503001765 CA Practitioner - Physical Therapist in Private Practice 9931596368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

910 Hale PL
Suite 115
Chula Vista, CA 91914-3504
Phone (619) 369-2667

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT301881CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

910 Hale Pl
Ste 115
Chula Vista, CA 91914
Phone (619) 369-2667

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

552 S Paseo Dorotea
Ste 4
Palm Springs, CA 92264
Phone (760) 325-5945

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1316681158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "888-208-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HALE PL STE 115",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143504",
            "telephone_number": "619-369-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPAUCO",
        "first_name": "RYDELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT301881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

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