Jason P Van Dyke, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 25655 Issued in CA

Practice address

215 S Hickory St
Ste 224
Escondido, CA 92025-4393

Phone

(760) 839-2905

Fax

(760) 839-2901

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  dba Logan Heights Family Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego Inc

  dba FamilyHealth at City College

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1952729303
  NPD
• Family Health Centers of San Diego, Inc

  dba Escondido Physical Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• MDRS Spine & Sport, Inc

  • Physical Therapist
  • Temecula, CA
  • NPI 1689824203
  NPD (past)
• MDRS Spine & Sport, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1952394603

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487658720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5395 RUFFIN RD",
            "address_2": "STE 201",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231338",
            "telephone_number": "800-219-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST",
            "address_2": "STE 224",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254393",
            "telephone_number": "760-839-2905",
            "fax_number": "760-839-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "JASON",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 25655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPT251550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Richard Van Goethem
• Melissa Van Grol, LCSW, PPSC
• Ruth Elaine Van Hasselt, SLP
• Sarah Van Woert
• Danielle Vanderford

• Physical Therapist in Escondido, CA
• Providers in Escondido, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.