Individual provider Active NPI

Leslie Davis Rudzinski, PT

  • Orthopedic Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1356449540
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT14916 Issued in CA
Practice address
10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943
Phone
(310) 286-0447
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT14916 CA Primary

Addresses

Primary practice location

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943

Mailing address

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050608000849 CA Practitioner - Physical Therapist in Private Practice 5496798696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prosport Physical Therapy Professionals IncGroup PAC ID 0749510634, 93 clinicians
Paulseth and Associates Physical Therapy IncGroup PAC ID 9638074073, 5 clinicians

Practice addresses (Care Compare)

10351 Santa Monica Blvd
Suite 101
Los Angeles, CA 90025-6943
Phone (310) 286-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14916CAMDOptometrist
PT14916CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Orthopedic Current Accepting new patients
Prosport Physical Therapy Professionals Inc CurrentSince Dec 6, 2022 Accepting new patients
Prosport Physical Therapy Professionals Inc Orthopedic CurrentSince Dec 6, 2022 Accepting new patients

Locations

559 E Carson St
Ste B
Carson, CA 90745
Phone (424) 201-5242

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

10351 Santa Monica Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 286-0447

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1356449540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943",
            "telephone_number": "310-286-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDZINSKI",
        "first_name": "LESLIE",
        "middle_name": "DAVIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT14916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.