NPIMap

Organization Active NPI

Newbury Park Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Newbury Park, CA
National Provider Identifier
1417046053
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEWBURY PARK PHYSICAL THERAPY INC.
Practice address
2814 Camino Dos Rios Ste 406
Newbury Park, CA 91320-1156
Phone
(805) 375-1461
Fax
(805) 498-7613
NPI assigned
Oct 12, 2006
Last updated
Jan 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Bernardine Thomas, P.T.NPI 1528285269
Title
Owner
Phone
(805) 375-1461

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 Therapy Clinic/Center 261QP2000X CA Primary

Addresses

Primary practice location

2814 Camino Dos Rios Ste 406
Newbury Park, CA 91320-1156

Mailing address

2814 Camino Dos Rios Ste 406
Newbury Park, CA 91320-1156
Phone (805) 375-1461

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524001482 CA Part B Supplier - Clinic/Group Practice 6204817596 Receives reassigned benefits from 8 practitioners
Practice locations: Newbury Park, CA

National Provider Directory

National Provider Directory

Locations

2814 Camino Dos Rios
Ste 406
Newbury Park, CA 91320
Phone (805) 375-1461

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1417046053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 CAMINO DOS RIOS STE 406",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913201156",
            "telephone_number": "805-375-1461",
            "fax_number": "805-498-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 CAMINO DOS RIOS STE 406",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913201156",
            "telephone_number": "805-375-1461",
            "fax_number": "805-498-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBURY PARK PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BERNARDINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-375-1461",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 11, 2023; 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.