Individual provider Active NPI

Andrea Janelle Jimenez

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1427908458
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
309177 Issued in CA
Practice address
585 Saturn Blvd
San Diego, CA 92154-4721
Phone
(619) 591-1190
NPI assigned
Jan 29, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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 309177 CA Primary

Addresses

Primary practice location

585 Saturn Blvd
San Diego, CA 92154-4721

Mailing address

68 Tranquilo LN
Chula Vista, CA 91911-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260310003185 CA Practitioner - Physical Therapist in Private Practice 3375026149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2600 Dallas Pkwy
Suite 290
Frisco, TX 75034-7486

2600 Dallas Pkwy
Suite 290
Frisco, TX 75034-7493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
309177CAMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 20, 2025 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Dec 20, 2025 Accepting new patients

Organizations & group practices 2

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": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1427908458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 TRANQUILO LN",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919113555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 SATURN BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921544721",
            "telephone_number": "619-591-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ANDREA",
        "middle_name": "JANELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "309177",
            "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 Jan 29, 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.