Organization Active NPI

My Physio for Life

  • Physical Therapist
  • Oceanside, CA
National Provider Identifier
1457014896
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MY PHYSIO FOR LIFE
Practice address
3600 Ocean Ranch Blvd
Oceanside, CA 92056-2669
Phone
(760) 696-3373
Fax
(877) 559-5308
NPI assigned
Oct 21, 2021
Last updated
Oct 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Carolyn Bowe-McLeod
Title
Billing Manager
Phone
(760) 433-7944

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

3600 Ocean Ranch Blvd
Oceanside, CA 92056-2669

Mailing address

3600 Ocean Ranch Blvd
Oceanside, CA 92056-2669
Phone (760) 696-3373

Other identifiers 1

IdentifierTypeStateIssuer
PT293401OtherCASTATE LICENSE

Other names 2

  • Ilana Tunca, DPT Former legal business name
  • Ilana Cartun, DPT Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220217001467 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2163815036 Receives reassigned benefits from 6 practitioners
Practice locations: Oceanside, CA

National Provider Directory

National Provider Directory

Locations

3600 Ocean Ranch Blvd
Oceanside, CA 92056
Phone (760) 696-3373

Practitioners & affiliated clinicians

Practitioners 6

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": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1457014896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OCEAN RANCH BLVD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562669",
            "telephone_number": "760-696-3373",
            "fax_number": "877-559-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OCEAN RANCH BLVD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920562669",
            "telephone_number": "760-696-3373",
            "fax_number": "877-559-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PHYSIO FOR LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "BOWE-MCLEOD",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "760-433-7944"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT293401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ilana Tunca, DPT",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Ilana Cartun, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.