Individual provider Active NPI

Hazel Fatima Cruz

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1407620347
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305140 Issued in CA
Practice address
5359 Balboa Blvd Ste a
Encino, CA 91316-2834
Phone
(310) 273-0877
NPI assigned
Nov 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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 305140 CA Primary

Addresses

Primary practice location

5359 Balboa Blvd Ste a
Encino, CA 91316-2834

Mailing address

18832 Pinehaven Way
Northridge, CA 91326-3955
Phone (818) 645-9111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220000674 CA Practitioner - Physical Therapist in Private Practice 2264876176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehab Specialists IncGroup PAC ID 7810071958, 25 clinicians

Practice addresses (Care Compare)

2730 Wilshire Blvd
Suite 533
Santa Monica, CA 90403-4751
Phone (310) 273-0877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists, Inc Physical Therapist CurrentSince Jan 2, 2023 Accepting new patients
Adi Rehab, Incorporated Physical Therapist PastSince Nov 24, 2019 Accepting new patients

Locations

5359 Balboa Blvd
Ste A
Encino, CA 91316
Phone (818) 506-7821

2730 Wilshire Blvd
Ste 533
Santa Monica, CA 90403
Phone (310) 273-0870

10635 Santa Monica Blvd
Ste 165
West Los Angeles, CA 90025
Phone 3102730877143

Organizations & group practices 2

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": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1407620347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18832 PINEHAVEN WAY",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913263955",
            "telephone_number": "818-645-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 BALBOA BLVD STE A",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162834",
            "telephone_number": "310-273-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "HAZEL FATIMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.