Individual provider Active NPI

Anissa Ling, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1356797419
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT306196 Issued in CA
Practice address
4879 Coronado Ave
San Diego, CA 92107-3315
Phone
(619) 391-8688
Fax
(512) 539-0034
NPI assigned
May 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 PT306196 CA Primary

Addresses

Primary practice location

4879 Coronado Ave
San Diego, CA 92107-3315

Mailing address

4879 Coronado Ave
San Diego, CA 92107-3315
Phone (615) 373-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601000854 TX Practitioner - Physical Therapist in Private Practice 9436449691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Physical Therapy Specialists, IncGroup PAC ID 2567422538, 238 clinicians

Practice addresses (Care Compare)

101 Medical Pkwy
Suite 110
Lakeway, TX 78738-5647
Phone (512) 879-4343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306196CAMDRegistered Nurse
PT306196CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Physical Therapy Specialists, Inc. Physical Therapist CurrentSince Oct 10, 2025 Accepting new patients
Texas Physical Therapy Specialists CurrentSince Oct 10, 2025 Accepting new patients
Agilitas USA, Inc Past Accepting new patients

Locations

11150 Research Blvd
Ste 212
Austin, TX 78759
Phone (512) 794-8863

101 Medical Pkwy
Ste 110
Lakeway, TX 78738
Phone (512) 879-4343

1789 S Bagdad Rd
Ste 102
Leander, TX 78641
Phone (512) 337-8970

7505 N Loop 1604 E
Ste 101
Live Oak, TX 78233
Phone (210) 590-4000

1324 E Common St
Ste 307
New Braunfels, TX 78130
Phone (830) 625-7310

Organizations & group practices 3

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": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1356797419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4879 CORONADO AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073315",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4879 CORONADO AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073315",
            "telephone_number": "619-391-8688",
            "fax_number": "512-539-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LING",
        "first_name": "ANISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT306196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.