Active NPI
Fardad Komaili, DPT
- Physical Therapist
- Newport Beach, CA
National Provider Identifier
1497314553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 294258
- Practice address
- 466 Flagship Rd
Newport Beach, CA 92663-3635 - Phone
- (949) 642-8044
- NPI assigned
- Jun 11, 2019
- Last updated
- Jun 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 294258 | CA | Primary |
Addresses
Primary practice location
466 Flagship Rd
Newport Beach, CA 92663-3635
Mailing address
15531 Belshire Ave Apt 25
Norwalk, CA 90650-6724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Spring, TX 77379
Phone (832) 570-2284
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 294258 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empower Health LLC | Physical Therapist | Current | Accepting new patients |
| Adaptive Rehabilitation Clinics, LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 4
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.
-
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- Spring, TX
- NPI 1346057031
Physical Therapist
-
- Physical Therapist
- Southlake, TX
- NPI 1790309656
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1497314553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15531 BELSHIRE AVE APT 25",
"city": "NORWALK",
"state": "CA",
"postal_code": "906506724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "466 FLAGSHIP RD",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926633635",
"telephone_number": "949-642-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOMAILI",
"first_name": "FARDAD",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-11",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "CA",
"license": "294258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.