Individual provider Active NPI

Michelle C Mezin

  • Physical Therapist
  • Laguna Niguel, CA
National Provider Identifier
1336700285
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT296766 Issued in CA
Practice address
30100 Town Center Drive
Suite Yz
Laguna Niguel, CA 92677-1250
Phone
(949) 276-5401
Fax
(949) 276-5403
NPI assigned
Jun 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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 PT296766 CA Primary

Addresses

Primary practice location

30100 Town Center Drive
Suite Yz
Laguna Niguel, CA 92677-1250

Mailing address

23521 Paseo de Valencia
Suite B7
Laguna Hills, CA 92653-2843
Phone (949) 597-0007

Other identifiers 1

IdentifierTypeStateIssuer
PT296766OtherCAPT LICENSE

Other names 1

  • Michelle C Zens Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michellez@rauschpt.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911002774 CA Practitioner - Physical Therapist in Private Practice 8729317094 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CPRX, IncorporatedGroup PAC ID 7315934486, 7 clinicians

Practice addresses (Care Compare)

3662 Katella Ave
Suite 105
Los Alamitos, CA 90720-3180
Phone (562) 799-4494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT296766CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Impt, Inc. Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
CPRX, Incorporated Physical Therapist CurrentSince Nov 18, 2022 Accepting new patients
Pack Physical Therapy, Inc. Physical Therapist PastSince Jul 1, 2012 Accepting new patients

Locations

16561 Bolsa Chica St
Ste 100
Huntington Beach, CA 92649
Phone (714) 364-1313

17332 Von Karman Ave
Ste 120
Irvine, CA 92614
Phone (949) 861-8600

3662 Katella Ave
Ste 105
Los Alamitos, CA 90720
Phone (562) 799-4494

3662 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-4494

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1336700285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23521 PASEO DE VALENCIA",
            "address_2": "SUITE B7",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926532843",
            "telephone_number": "949-597-0007",
            "fax_number": "948-597-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DRIVE",
            "address_2": "SUITE YZ",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926771250",
            "telephone_number": "949-276-5401",
            "fax_number": "949-276-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZIN",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT296766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT296766",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michellez@rauschpt.net",
            "affiliation": "N",
            "address_1": "30100 Town Center Dr Ste Yz",
            "city": "Laguna Niguel",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926772064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ZENS",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.