Jonathan Lyle Andersen, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

33070 Issued in CA

Practice address

3500 Coffee Rd
Suite 3
Modesto, CA 95355-1344

Phone

(209) 342-2300

Fax

(209) 524-4240

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Andersen Physical Therapy IncGroup PAC ID 3678520244, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

41.39 of 100Reported as individual

Quality

38.33

Improvement activities

0

Cost

80.71

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Andersen Physical Therapy, Inc

  • Physical Therapist
  • Modesto, CA
  • NPI 1225029630
  Medicare reassignment Care Compare group NPD
• Andersen Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Turlock, CA
  • NPI 1891520185
  NPD Authorized official

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346326550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 COFFEE RD",
            "address_2": "SUITE 3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551344",
            "telephone_number": "209-342-2300",
            "fax_number": "209-524-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "JONATHAN",
        "middle_name": "LYLE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Ancira, CM
• Sonia Ramirez Andalon
• Brigida Estabillo Andaya, MD
• Kathy R Anderegg, REGISTERED NURSE
• Andersen Physical Therapy, Inc
• Lyle Melvin Andersen, PT
• Sherilyn Ann Andersen, PT
• Stacey L. Anderson Young, LMFT
• Kiley Marie Anderson-Thompson
• Robin Marie Anderson-Wood

• Physical Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.