Individual provider Active NPI

Kassandra Tayag, PT, DPT

  • Physical Therapist
  • Brea, CA
National Provider Identifier
1316683378
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302046 Issued in CA
Practice address
3230 E Imperial Hwy Ste 100
Brea, CA 92821-6735
Phone
(714) 256-5074
Fax
(714) 256-0770
NPI assigned
May 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 302046 CA Primary

Addresses

Primary practice location

3230 E Imperial Hwy Ste 100
Brea, CA 92821-6735

Mailing address

3230 E Imperial Hwy Ste 100
Brea, CA 92821-6735
Phone (714) 256-5074

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220725001688 CA Practitioner - Physical Therapist in Private Practice 4486035284 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coury & Buehler Physical Therapy, Inc. Physical Therapist Current Accepting new patients
Coury & Buehler Physical Therapy, Inc. Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Coury & Buehler Physical Therapy - Lake Forest, Inc. Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Coury & Buehler Physical Therapy, Inc. Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Coury & Buehler Physical Therapy - Irvine, Inc. Physical Therapist CurrentSince May 9, 2022 Accepting new patients
Coury & Buehler Physical Therapy - Irvine, Inc. Physical Therapist CurrentSince May 9, 2022 Accepting new patients

Locations

755 N Shepard St
Anaheim, CA 92806
Phone (714) 630-6252

3230 E Imperial Hwy
Ste 100
Brea, CA 92821
Phone (714) 256-5074

32 Discovery
Ste 100
Irvine, CA 92618
Phone (949) 271-0010

250 E Yale Loop
Ste 201
Irvine, CA 92604
Phone (949) 265-2442

24301 Muirlands Blvd
Ste T
Lake Forest, CA 92630
Phone (949) 271-0012

3300 Irvine Ave
Ste 130
Newport Beach, CA 92660
Phone (949) 271-0053

239 E Katella Ave
Orange, CA 92867
Phone (714) 538-0025

Organizations & group practices 6

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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1316683378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216735",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 E IMPERIAL HWY STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216735",
            "telephone_number": "714-256-5074",
            "fax_number": "714-256-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYAG",
        "first_name": "KASSANDRA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.