Ivan Daniel Vicario, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40409 Issued in CA

Practice address

900 Wilshire Blvd
315
Santa Monica, CA 90401-1872

Phone

(310) 434-2400

NPI assigned

Aug 20, 2013

Last updated

Aug 26, 2013By 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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gaspar Physical Therapy a Professional CorporationGroup PAC ID 0648165761, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Gaspar Physical Therapy a Professional Corporation

  dba Doctors of Physical Therapy

  • Specialist
  • Carlsbad, CA
  • NPI 1952544405

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Gaspar Physical Therapy a Professional Corporation

  dba Doctors of Physical Therapy

  • Specialist
  • San Diego, CA
  • NPI 1154779759
  NPD
• Holistic Physical Therapy and Wellness, Inc

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1124559083
  NPD

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1427481902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILSHIRE BLVD",
            "address_2": "#315",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011872",
            "telephone_number": "858-342-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILSHIRE BLVD",
            "address_2": "315",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011872",
            "telephone_number": "310-434-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICARIO",
        "first_name": "IVAN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vert Center of Santa Monica (Vert Sport Therapy and Rehab)
• Vert Westside LP (VERT Sports Therapy and Rehabilitation)
• Savithri Natasha Vethavanam, ASW
• Jeremiah Vettichira
• Lisa Marie Viapiano, D.C.
• Victor Medical Corporation
• Alicia Victorero, LVN
• Victoria Davidovsky-Lucas, a Professional Chiropractic Corporation
• Victorias House, LLC
• Erik Vicuna

• Physical Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.