NPIMap

Organization Active NPI

Ocean Physical Therapy, Inc.

  • Physical Therapist
  • San Clemente, CA
National Provider Identifier
1396895512
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
OCEAN PHYSICAL THERAPY, INC.
Practice address
901 Calle Amanecer
Ste 320
San Clemente, CA 92673-6278
Phone
(949) 366-6785
Fax
(949) 366-6470
NPI assigned
Jan 11, 2007
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Mrs. Lissa Trevino, P.T.NPI 1669551750
Title
President
Phone
(949) 366-6785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

901 Calle Amanecer
Ste 320
San Clemente, CA 92673-6278

Mailing address

901 Calle Amanecer
Ste 320
San Clemente, CA 92673-6278
Phone (949) 366-6785

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091118000294 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5890782734 Receives reassigned benefits from 4 practitioners
Practice locations: San Clemente, CA

National Provider Directory

National Provider Directory

Locations

901 Calle Amanecer
Ste 320
San Clemente, CA 92673
Phone (949) 366-6785

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1396895512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "STE 320",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736278",
            "telephone_number": "949-366-6785",
            "fax_number": "949-366-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CALLE AMANECER",
            "address_2": "STE 320",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736278",
            "telephone_number": "949-366-6785",
            "fax_number": "949-366-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "LISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-366-6785",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.