Individual provider Active NPI

Tracy Ann Cheevers

  • Physical Medicine & Rehabilitation Physician
  • Newbury Park, CA
National Provider Identifier
1407985054
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
22621 Issued in CA
Practice address
1001 Newbury Rd
Newbury Park, CA 91320-6434
Phone
(805) 375-7900
NPI assigned
Mar 2, 2007
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 22621 CA Primary

Addresses

Primary practice location

1001 Newbury Rd
Newbury Park, CA 91320-6434

Mailing address

1001 Newbury Rd
Newbury Park, CA 91320-6434
Phone (805) 375-7900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000827 CA Practitioner - Physical Therapist in Private Practice 3173426442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic and Neurological Rehab IncGroup PAC ID 6507159126, 368 clinicians

Practice addresses (Care Compare)

3575 N Moorpark Rd
Thousand Oaks, CA 91360-2666
Phone (512) 327-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc CurrentSince Dec 16, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 28, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 28, 2022 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Dec 16, 2023 Accepting new patients
Southern California Permanente Medical Group Current 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

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

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

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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

3575 N Moorpark Rd
Thousand Oaks, CA 91360
Phone (805) 244-8422

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

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

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

Organizations & group practices 5

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1407985054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NEWBURY RD",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206434",
            "telephone_number": "805-375-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NEWBURY RD",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206434",
            "telephone_number": "805-375-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEEVERS",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "22621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newbury Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.