Individual provider Active NPI

Tyrone G McSorley, PT OCS ATC

  • Orthopedic Physical Therapist
  • San Luis Obispo, CA
National Provider Identifier
1427100676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT22262 Issued in CA
Practice address
894 Meinecke Ave # B
San Luis Obispo, CA 93405
Phone
(805) 546-8040
Fax
(805) 546-0440
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT22262 CA Primary

Addresses

Primary practice location

894 Meinecke Ave # B
San Luis Obispo, CA 93405

Mailing address

894 Meinecke Ave # B
San Luis Obispo, CA 93405
Phone (805) 546-8040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000357 CA Practitioner - Physical Therapist in Private Practice 4284674417 Receives reassigned benefits from 1 practitioner
Practice locations: San Luis Obispo, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

894 Meinecke Ave
Suite B
San Luis Obispo, CA 93405-1791
Phone (805) 546-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22262CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Physical Therapy PastSince Jan 1, 2002 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427100676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 MEINECKE AVE # B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-546-8040",
            "fax_number": "805-546-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 MEINECKE AVE # B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-546-8040",
            "fax_number": "805-546-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSORLEY",
        "first_name": "TYRONE",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PT OCS ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT22262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.