Individual provider Active NPI

Mary Grace Guevarra, P.T.

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1386776144
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32582 Issued in CA
Practice address
2211 W Magnolia Blvd Ste 160
Burbank, CA 91506-1757
Phone
(818) 876-4195
Fax
(818) 729-0410
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 32582 CA
Physical Therapist 225100000X 32582 CA Primary

Addresses

Primary practice location

2211 W Magnolia Blvd Ste 160
Burbank, CA 91506-1757

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1017 S Fair Oaks Ave
Pasadena, CA 91105-2621
Phone (626) 403-6200

Other identifiers 1

IdentifierTypeStateIssuer
32582OtherCACA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000767 CA Practitioner - Physical Therapist in Private Practice 4486754470 Reassigns benefits to 1 organization

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
Group practices
Regents of the University of CaliforniaGroup PAC ID 5294958815, 84 clinicians

Practice addresses (Care Compare)

2211 W Magnolia Blvd
Suite 160
Burbank, CA 91506-1757
Phone (661) 284-3155

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
87.27
Promoting interoperability
100
Improvement activities
40
Cost
74.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32582CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jul 11, 2016 Accepting new patients
Regents of the University of California CurrentSince Jul 11, 2016 Accepting new patients
PT RN Care Inc Physical Therapist PastSince Aug 1, 2005 Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

2211 W Magnolia Blvd
Ste 160
Burbank, CA 91506
Phone (818) 876-4195

1000 Flower St
Glendale, CA 91201
Phone (818) 659-5000

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 59755
Los Angeles, CA 90074

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1386776144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 W MAGNOLIA BLVD STE 160",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061757",
            "telephone_number": "818-876-4195",
            "fax_number": "818-729-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1017 S Fair Oaks Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911052621",
            "country_code": "US",
            "telephone_number": "626-403-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARRA",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "32582",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "32582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "32582",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.