Derek Mario Decicco, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

33639 Issued in CA

Practice address

15775 Laguna Canyon Rd Ste 110
Irvine, CA 92618-3192

Phone

(714) 858-4617

NPI assigned

May 28, 2009

Last updated

Feb 4, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Restorative Therapy AssociatesGroup PAC ID 3072782705, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Restorative Therapy Associates

  • Physical Therapist
  • Irvine, CA
  • NPI 1902102023
  Medicare reassignment Care Compare group NPD Authorized official
• Restorative Therapy Associates

  dba MVP Physical Therapy

  • Physical Therapy Clinic/Center
  • Lake Forest, CA
  • NPI 1023311073

  Physical Therapist

  NPD Authorized official

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296777600000",
    "number": "1427283894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 MISSION DR",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264209",
            "telephone_number": "714-382-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15775 LAGUNA CANYON RD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183192",
            "telephone_number": "714-858-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECICCO",
        "first_name": "DEREK",
        "middle_name": "MARIO",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2011-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Nicole Deanda
• Grace A Dearmin, NONE
• Hilary Sarah Dearth, M.A., BCBA
• Stacy Debrow
• Kimberly Ahluwalia Dechellis, LMFT
• Karen Matsumoto Deck, N.P.
• Joseph Douglas Dedeaux
• Deepika Dhama, D.D.S. (Culver Smiles Dentistry)
• Brittany Deering
• Anton J Degeus, DDS

• Physical Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.