Individual provider Active NPI

Morris Shapow, RPT

  • Physical Therapist
  • Encino, CA
National Provider Identifier
1477609733
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6166 Issued in CA
Practice address
5359 Balboa Blvd
Encino, CA 91316-2803
Phone
(818) 304-0990
Fax
(818) 304-0996
NPI assigned
Jan 26, 2007
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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 PT6166 CA Primary

Addresses

Primary practice location

5359 Balboa Blvd
Encino, CA 91316-2803

Mailing address

5359 Balboa Blvd
Encino, CA 91316-2803
Phone (818) 304-0990

Other identifiers 1

IdentifierTypeStateIssuer
1477609733OtherCATYPE II

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512001004 CA Practitioner - Physical Therapist in Private Practice 1850330879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3110 Main St
BLDG C
Santa Monica, CA 90405-0001
Phone (310) 492-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6166CAMDPhysical Therapist
6166CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
BKP Chiropractic & Rehabilitation Past Accepting new patients
Joint Effort Medical Wellness Physical Therapist PastSince Aug 1, 2004 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1477609733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5359 BALBOA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162803",
            "telephone_number": "818-304-0990",
            "fax_number": "818-304-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 BALBOA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162803",
            "telephone_number": "818-304-0990",
            "fax_number": "818-304-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPOW",
        "first_name": "MORRIS",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT6166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II",
            "identifier": "1477609733",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.