Individual provider Active NPI

Susan Gemmill Faltico, MS, PT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1396815494
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 26596 Issued in CA
Practice address
2250 Caminito Pescado Unit 5
San Diego, CA 92107-1925
Phone
(619) 795-1657
Fax
(619) 795-1657
NPI assigned
Nov 8, 2006
Last updated
Apr 7, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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 PT 26596 CA Primary

Addresses

Primary practice location

2250 Caminito Pescado Unit 5
San Diego, CA 92107-1925

Mailing address

2250 Caminito Pescado Unit 5
San Diego, CA 92107-1925
Phone (619) 795-1657

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123001062 CA Practitioner - Physical Therapist in Private Practice 7810911377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT 26596CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Oct 3, 2023 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Oct 3, 2023 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince May 11, 2023 Accepting new patients
In-Home Physical Therapy PC PastSince Nov 1, 2019 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 571-2603

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1396815494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CAMINITO PESCADO UNIT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921071925",
            "telephone_number": "619-795-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 CAMINITO PESCADO UNIT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921071925",
            "telephone_number": "619-795-1657",
            "fax_number": "619-795-1657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALTICO",
        "first_name": "SUSAN",
        "middle_name": "GEMMILL",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 26596",
            "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 Apr 7, 2010; 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.