Individual provider Active NPI

Melissa Owen, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1417654377
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
054477 Issued in NY
Practice address
5030 Camino de la Siesta Ste 220
San Diego, CA 92108-3118
Phone
(619) 260-0750
NPI assigned
Feb 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT302824 CA
Physical Therapist 225100000X 054477 NY Primary

Addresses

Primary practice location

5030 Camino de la Siesta Ste 220
San Diego, CA 92108-3118

Mailing address

5030 Camino de la Siesta Ste 220
San Diego, CA 92108-3118
Phone (619) 260-0750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250812001135 NY Practitioner - Physical Therapist in Private Practice 6901304658 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

279 Larkfield Rd
East Northport, NY 11731-2415
Phone (631) 262-1370

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

9785 Queens Blvd
Rego Park, NY 11374-3319
Phone (718) 261-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT302824CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Physical Therapy Inc Physical Therapist CurrentSince Feb 12, 2023 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Aug 5, 2025 Accepting new patients

Locations

5030 Camino de la Siesta
Ste 220
San Diego, CA 92108
Phone (619) 260-0750

279 Larkfield Rd
East Northport, NY 11731
Phone (631) 261-1370

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1417654377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083118",
            "telephone_number": "619-260-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CAMINO DE LA SIESTA STE 220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083118",
            "telephone_number": "619-260-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "MELISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT302824",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.