NPIMap

Organization Active NPI

Genesis Physical Therapy Inc.

  • Physical Therapist
  • Simi Valley, CA
National Provider Identifier
1467467282
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26886 Issued in CA
Legal business name
GENESIS PHYSICAL THERAPY INC.
Practice address
2807 E. Cochran Street
Simi Valley, CA 93065-1207
Phone
(805) 583-9575
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Ms. Pilar Marie Hanes, MPT
Title
Owner
Phone
(805) 583-9575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT26886 CA Primary

Addresses

Primary practice location

2807 E. Cochran Street
Simi Valley, CA 93065-1207

Mailing address

PO Box 1448
Simi Valley, CA 93062-1448
Phone (805) 583-9575

Other identifiers 2

IdentifierTypeStateIssuer
607330100OtherCADEPT OF LABOR
ZZZ65708ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001445 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8628068962 Receives reassigned benefits from 3 practitioners
Practice locations: Simi Valley, CA; West Hills, CA

National Provider Directory

National Provider Directory

Locations

2807 Cochran St
Simi Valley, CA 93065
Phone (805) 583-9575

2925 Sycamore Dr
Ste 101A
Simi Valley, CA 93065
Phone (805) 578-9751

7301 Medical Center Dr
Ste 209
West Hills, CA 91307
Phone (805) 530-3838

22110 Roscoe Blvd
Ste 106
West Hills, CA 91304
Phone (818) 704-4225

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1467467282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1448",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930621448",
            "telephone_number": "805-583-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 E. COCHRAN STREET",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651207",
            "telephone_number": "805-583-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "HANES",
        "authorized_official_first_name": "PILAR",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-583-9575",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "607330100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65708Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.