Individual provider Active NPI

Lyndsie Von Javier, DPT

  • Physical Therapist
  • San Dimas, CA
National Provider Identifier
1457604274
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT39325 Issued in CA
Practice address
1740 S San Dimas Ave
San Dimas, CA 91773-5108
Phone
(909) 394-0304
Fax
(909) 305-4647
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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 PT39325 CA Primary

Addresses

Primary practice location

1740 S San Dimas Ave
San Dimas, CA 91773-5108

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200319002507 MD Practitioner - Physical Therapist in Private Practice 5890948806 Reassigns benefits to 2 organizations
I20200325001321 DC Practitioner - Physical Therapist in Private Practice 5890948806 Reassigns benefits to 1 organization
I20230414002072 AZ Practitioner - Physical Therapist in Private Practice 5890948806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

5803 W Northern Ave
Suite 110
Glendale, AZ 85301-1362
Phone (623) 295-3699

Merit-based Incentive Payment System (MIPS)

Final score
86.09 of 100Reported as group
Quality
89.13
Improvement activities
40
Cost
73.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27836MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 27, 2020 Accepting new patients
Ati Holdings of Arizona, LLC Physical Therapist CurrentSince Jan 26, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jan 27, 2020 Accepting new patients
Ati Holdings, LLC Past Accepting new patients
Ideal Rehabilitation LLC Past Accepting new patients

Locations

1485 E Florence Blvd
Ste 105
Casa Grande, AZ 85122
Phone (520) 494-3058

5803 W Northern Ave
Ste 110
Glendale, AZ 85301
Phone (623) 295-3699

11209 N Tatum Blvd
Ste B120
Phoenix, AZ 85028
Phone (602) 595-0204

5110 S Rural Rd
Ste 104
Tempe, AZ 85282
Phone (480) 629-5549

1020 S Harrison Rd
Unit 120
Tucson, AZ 85748
Phone (520) 207-6288

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

137 W High St
Ste 3
Elkton, MD 21921
Phone (410) 392-7027

137 W High St
Ste 3A
Elkton, MD 21921
Phone (410) 392-7027

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

4853 Pulaski Hwy
Ste 315
Perryville, MD 21903
Phone (443) 693-8000

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

Organizations & group practices 5

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": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1457604274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 S SAN DIMAS AVE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917735108",
            "telephone_number": "909-394-0304",
            "fax_number": "909-305-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVIER",
        "first_name": "LYNDSIE",
        "middle_name": "VON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT39325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.