Individual provider Active NPI

Timothy Bryant Hornak, OTR/L

  • Occupational Therapist
  • Newport Beach, CA
National Provider Identifier
1417434390
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18895 Issued in CA
Practice address
200 Newport Center Dr Ste 213
Newport Beach, CA 92660-7503
Phone
(949) 644-1322
NPI assigned
Jul 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 18895 CA Primary

Addresses

Primary practice location

200 Newport Center Dr Ste 213
Newport Beach, CA 92660-7503

Mailing address

22352 Shadow RDG
Mission Viejo, CA 92692-4817

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190104002044 CA Practitioner - Occupational Therapist in Private Practice 8820334303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

471 W Lambert Rd
Suite 106
Brea, CA 92821-3921
Phone (714) 255-8877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Current Accepting new patients
California Rehab & Sports Therapy CurrentSince Jun 27, 2018 Accepting new patients
California Rehabilitation & Sports Therapy a California Physical Ther CurrentSince Jun 27, 2018 Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

14135 Francisquito Ave
Ste 100
Baldwin Park, CA 91706
Phone (626) 430-2300

471 W Lambert Rd
Ste 106
Brea, CA 92821
Phone (714) 255-8877

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

7071 Warner Ave
Ste A
Huntington Beach, CA 92647
Phone (714) 847-3800

2888 Long Beach Blvd
Ste 405
Long Beach, CA 90806
Phone (562) 595-4489

5810 Downey Ave
Long Beach, CA 90805
Phone (562) 380-2178

200 Newport Center Dr
Ste 213
Newport Beach, CA 92660
Phone (949) 644-0316

Organizations & group practices 3

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": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1417434390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22352 SHADOW RDG",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926924817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR STE 213",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607503",
            "telephone_number": "949-644-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNAK",
        "first_name": "TIMOTHY",
        "middle_name": "BRYANT",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "18895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.