Alexei Lyapustin, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT38613 Issued in CA

Practice address

78078 Country Club Dr
Suite 205
Bermuda Dunes, CA 92203-8173

Phone

(760) 345-9934

Fax

(760) 345-3086

NPI assigned

Oct 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1407108632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 NINA PL",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524110",
            "telephone_number": "240-888-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78078 COUNTRY CLUB DR",
            "address_2": "SUITE 205",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922038173",
            "telephone_number": "760-345-9934",
            "fax_number": "760-345-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYAPUSTIN",
        "first_name": "ALEXEI",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT38613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda King
• Biljana Kostic, M.D.
• Jeffrey Dale Lawhead, MD
• Peihua Lee, DPT
• Crystal Lestari, PHARMD
• Joseph Bautista Manalo, PT
• Fred H Mann, RPH
• Susan Marder, ANP-C
• Mattie Evans Alderman Foundation for Preventive Medicine, Inc.
• Mattie Evans Alderman Foundation, Inc.

• Physical Therapist in Bermuda Dunes, CA
• Providers in Bermuda Dunes, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.