Ellen Dale, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

34119 Issued in CA

Practice address

2711 E Coast Hwy
Suite 206
Corona del Mar, CA 92625-2104

Phone

(949) 675-2922

Fax

(949) 675-2992

NPI assigned

Jun 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ellen Stephens Former name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of California, San Francisco School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kinetik Physical Therapy IncGroup PAC ID 7911381207, 4 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Kinetik Physical Therapy Inc

  dba Kinetik Performance and Rehab

  • Physical Therapist
  • Mission Viejo, CA
  • NPI 1396478616
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1376702373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 E COAST HWY",
            "address_2": "SUITE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 E COAST HWY",
            "address_2": "SUITE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252104",
            "telephone_number": "949-675-2922",
            "fax_number": "949-675-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE",
        "first_name": "ELLEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "STEPHENS",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maxine Beth Cohen, MFT
• Kathleen Ann Colao, LMFT, RDN
• Andrea Marie Colon, ND
• Eulalia Cortez
• Micah Crowley, D.M.D.
• Nori Deatherage
• Deva Health, Corp.
• Elisa Dombrowski, MFT
• Arlene Dorius, PH.D.
• Mona Dossani, FNP

• Physical Therapist in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; 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.