Individual provider Active NPI

Louis Dominic Moscardi, P.T.

  • Physical Therapist
  • Pismo Beach, CA
National Provider Identifier
1417972977
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28238 Issued in CA
Practice address
911 Oak Park Blvd Ste 105
Pismo Beach, CA 93449-3406
Phone
(805) 481-8272
Fax
(805) 481-8045
NPI assigned
Jul 13, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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 PT28238 CA Primary

Addresses

Primary practice location

911 Oak Park Blvd Ste 105
Pismo Beach, CA 93449-3406

Mailing address

911 Oak Park Blvd Ste 105
Pismo Beach, CA 93449-3406
Phone (805) 481-8272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000428 CA Practitioner - Physical Therapist in Private Practice 1153309364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

911 Oak Park Blvd
Suite 105
Pismo Beach, CA 93449-3406
Phone (805) 481-8272

Merit-based Incentive Payment System (MIPS)

Final score
23.29 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28238CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Moscardi Physical Therapy, Inc Physical Therapist CurrentSince Jul 1, 2006 Accepting new patients
Spearman MD Inc. Past Accepting new patients
Sports & Wellness Physical Therapy, Inc. Physical Therapist PastSince Aug 1, 2000 Accepting new patients

Locations

901 Oak Park Blvd
Ste 102
Pismo Beach, CA 93449
Phone (805) 481-8272

911 Oak Park Blvd
Ste 105
Pismo Beach, CA 93449
Phone (805) 349-8972

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, 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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1417972977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD STE 105",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-8272",
            "fax_number": "805-481-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 OAK PARK BLVD STE 105",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493406",
            "telephone_number": "805-481-8272",
            "fax_number": "805-481-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCARDI",
        "first_name": "LOUIS",
        "middle_name": "DOMINIC",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.