Individual provider Active NPI

Jessica Monaloy, PT

  • Physical Therapist
  • South Lake Tahoe, CA
National Provider Identifier
1376628552
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25234 Issued in CA
Practice address
3200 US Highway 50
Unit 5
South Lake Tahoe, CA 96150-9207
Phone
(530) 721-3253
Fax
(530) 285-2002
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25234 CA
Physical Therapist 225100000X 25234 CA Primary

Addresses

Primary practice location

3200 US Highway 50
Unit 5
South Lake Tahoe, CA 96150-9207

Mailing address

PO Box 550275
South Lake Tahoe, CA 96155-0275
Phone (530) 721-3253

Other identifiers 1

IdentifierTypeStateIssuer
0PT252340OtherCAMEDICARE PPIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060301000740 CA Practitioner - Physical Therapist in Private Practice 1456367333 Practice locations: South Lake Tahoe, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2311 Lake Tahoe Blvd
Suite 1
South Lake Tahoe, CA 96150-7104
Phone (530) 721-3253

2311 Lake Tahoe Blvd
Suite 1
South Lake Tahoe, CA 96150-7129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25234CAMDMarriage & Family Therapist
PT25234CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Meyers Physical Therapy CurrentSince Apr 1, 2014 Accepting new patients
Agile Physical Therapy Inc PastSince Feb 14, 2022 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist Past Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist Past Accepting new patients
Bodywise Physical Therapy Physical Therapist PastSince Aug 20, 2015 Accepting new patients
Sports & Orthopedic Leaders Physical Therapy, Inc Physical Therapist PastSince May 17, 2019 Accepting new patients
San Francisco Sport & Spine Physical Therapy Physical Therapist PastSince Oct 1, 2011 Accepting new patients
Marin Sport and Spine Physical Therapy Physical Therapist Past Accepting new patients

Locations

3200 US Highway 50
Unit 5
South Lake Tahoe, CA 96150
Phone (530) 517-0637

2311 Lake Tahoe Blvd
Ste 1
South Lake Tahoe, CA 96150
Phone (530) 721-3253

Organizations & group practices 8

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1376628552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550275",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961550275",
            "telephone_number": "530-721-3253",
            "fax_number": "530-285-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 US HIGHWAY 50",
            "address_2": "UNIT 5",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961509207",
            "telephone_number": "530-721-3253",
            "fax_number": "530-285-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONALOY",
        "first_name": "JESSICA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25234",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "25234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PPIN",
            "identifier": "0PT252340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.