Individual provider Active NPI

Janise Co Alcantara, PT

  • Physical Therapist
  • Long Beach, CA
National Provider Identifier
1376753194
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24987 Issued in CA
Practice address
1913 E 5TH St
Long Beach, CA 90802-2024
Phone
(562) 432-5751
Fax
(562) 435-6394
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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 24987 CA Primary

Addresses

Primary practice location

1913 E 5TH St
Long Beach, CA 90802-2024

Mailing address

5913 Pepperwood Ave
Lakewood, CA 90712-1142
Phone (562) 804-1860

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141231000603 CA Practitioner - Physical Therapist in Private Practice 0840513610 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Movement Medicine Physical Therapy and Wellness IncGroup PAC ID 8729471222, 4 clinicians

Practice addresses (Care Compare)

10854 Washington Blvd
Culver City, CA 90232-3610
Phone (323) 456-3856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BSP Physical Therapy Inc Physical Therapist CurrentSince Sep 15, 2021 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Aug 6, 2019 Accepting new patients
Movement Medicine Physical Therapy and Wellness Inc Physical Therapist CurrentSince Feb 5, 2020 Accepting new patients
Rehabcare Unlimited Corporation Physical Therapist Past Accepting new patients

Locations

500 E Olive Ave
Ste 325
Burbank, CA 91501
Phone (818) 955-5786

10854 Washington Blvd
Culver City, CA 90232
Phone (323) 456-3856

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1376753194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5913 PEPPERWOOD AVE",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121142",
            "telephone_number": "562-804-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 E 5TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022024",
            "telephone_number": "562-432-5751",
            "fax_number": "562-435-6394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALCANTARA",
        "first_name": "JANISE",
        "middle_name": "CO",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.