NPIMap

Organization Active NPI

BSP Physical Therapy Inc

  • Physical Therapist
  • Burbank, CA
National Provider Identifier
1447535380
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BSP PHYSICAL THERAPY INC
Practice address
500 E Olive Ave
Ste 325
Burbank, CA 91501-3316
Phone
(818) 955-5786
Fax
(818) 955-5789
NPI assigned
Oct 11, 2011
Last updated
May 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Authorized official

Name
Brynilla Pacheco, PTNPI 1780838607
Title
PT, President
Phone
(818) 955-5786

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

500 E Olive Ave
Ste 325
Burbank, CA 91501-3316

Mailing address

PO Box 606
Burbank, CA 91503-0606
Phone (818) 955-5786

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120119000129 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6507033388 Receives reassigned benefits from 9 practitioners
Practice locations: Burbank, CA

National Provider Directory

National Provider Directory

Locations

201 S Buena Vista St
Ste 355
Burbank, CA 91505
Phone (818) 333-7590

500 E Olive Ave
Ste 325
Burbank, CA 91501
Phone (818) 955-5786

10854 Washington Blvd
Culver City, CA 90232
Phone (323) 456-3856

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1447535380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915030606",
            "telephone_number": "818-955-5786",
            "fax_number": "818-955-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E OLIVE AVE",
            "address_2": "STE 325",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915013316",
            "telephone_number": "818-955-5786",
            "fax_number": "818-955-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSP PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "BRYNILLA",
        "authorized_official_title_or_position": "PT, PRESIDENT",
        "authorized_official_telephone_number": "818-955-5786",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.