Individual provider Active NPI

Deimzon Sy

  • Physical Therapist
  • Rancho Cucamonga, CA
National Provider Identifier
1447981931
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
10590 Town Center Dr Ste 100
Rancho Cucamonga, CA 91730-0361
Phone
(909) 948-1124
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 Primary

Addresses

Primary practice location

10590 Town Center Dr Ste 100
Rancho Cucamonga, CA 91730-0361

Mailing address

6955 San Bruno CT
Fontana, CA 92336-5059
Phone (909) 728-0932

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805000697 CA Practitioner - Physical Therapist in Private Practice 9739561887 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physical Therapy, Inc. Physical Therapist CurrentSince Jul 13, 2022 Accepting new patients
West Coast Spine Restoration Center, Inc Physical Therapist CurrentSince Oct 13, 2023 Accepting new patients

Locations

10590 Town Center Dr
Ste 100
Rch Cucamonga, CA 91730
Phone (909) 948-1124

6177 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 653-4480

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": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1447981931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6955 SAN BRUNO CT",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923365059",
            "telephone_number": "909-728-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 TOWN CENTER DR STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300361",
            "telephone_number": "909-948-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "DEIMZON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.