Individual provider Active NPI

Kristina Leean Mayer

  • Physical Therapist
  • Torrance, CA
National Provider Identifier
1487714846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27024 Issued in CA
Practice address
23560 Crenshaw Blvd
103
Torrance, CA 90505-5233
Phone
(310) 784-2366
Fax
(310) 517-0889
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 PT27024 CA Primary

Addresses

Primary practice location

23560 Crenshaw Blvd
103
Torrance, CA 90505-5233

Mailing address

23560 Crenshaw Blvd
103
Torrance, CA 90505-5233
Phone (310) 784-2366

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ02708ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000711 CA Practitioner - Physical Therapist in Private Practice 9032005301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redondo Orthopedic Physical TherapyGroup PAC ID 8729382668, 14 clinicians

Practice addresses (Care Compare)

520 N Prospect Ave
Suite 100
Redondo Beach, CA 90277-3033
Phone (310) 376-9222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT27024CAMDPhysical Therapist
27024CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Redondo Orthopedic Physical Therapy Physical Therapist CurrentSince Jan 1, 2016 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
South Bay Orthopaedic Specialists Medical Center a Medical Partnership PastSince Oct 1, 2001 Accepting new patients
Blake Physical Therapy, PC Physical Therapist PastSince Dec 16, 2002 Accepting new patients
Advanced Integrative Medical Center, Inc. PastSince Aug 6, 2019 Accepting new patients
Torrance Health Association Inc Past Accepting new patients

Locations

31228 Palos Verdes Dr W
Rch Palos Vrd, CA 90275
Phone (310) 544-7325

520 N Prospect Ave
Ste 100
Redondo Beach, CA 90277
Phone (310) 376-9222

Organizations & group practices 6

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487714846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23560 CRENSHAW BLVD",
            "address_2": "103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055233",
            "telephone_number": "310-784-2366",
            "fax_number": "310-517-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23560 CRENSHAW BLVD",
            "address_2": "103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055233",
            "telephone_number": "310-784-2366",
            "fax_number": "310-517-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "KRISTINA",
        "middle_name": "LEEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ02708Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.