Individual provider Active NPI

Maria Theresa Longakit Cecilio, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1366811903
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39598 Issued in CA
Practice address
11733 Stoney Peak Dr Apt 130
San Diego, CA 92128-4215
Phone
(916) 960-3776
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 39598 CA Primary

Addresses

Primary practice location

11733 Stoney Peak Dr Apt 130
San Diego, CA 92128-4215

Mailing address

11733 Stoney Peak Dr Apt 130
San Diego, CA 92128-4215

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200110002097 CA Practitioner - Physical Therapist in Private Practice 7911332465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1366811903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11733 STONEY PEAK DR APT 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11733 STONEY PEAK DR APT 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284215",
            "telephone_number": "916-960-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECILIO",
        "first_name": "MARIA THERESA",
        "middle_name": "LONGAKIT",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.