Active NPI
Paul Michael Lally, PT, DPT
- Physical Therapist
- San Diego, CA
National Provider Identifier
1508356130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT299985
- Practice address
- 7525 Metropolitan Dr Ste 306
San Diego, CA 92108-4404 - Phone
- (844) 316-7979
- Fax
- (866) 813-1235
- NPI assigned
- May 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT013485 | GA | |
| Physical Therapist | 225100000X | 11752 | TN | |
| Physical Therapist | 225100000X | PT299985 | CA | Primary |
Addresses
Primary practice location
7525 Metropolitan Dr Ste 306
San Diego, CA 92108-4404
Mailing address
7525 Metropolitan Dr Ste 306
San Diego, CA 92108-4404
Phone (844) 316-7979
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 299985 | Other | CA | PT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11752 | TN | MD | General Practice Dentistry |
| PT299985 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spinezone Medical Fitness, Inc. | Physical Therapist | Past | Accepting new patients |
| Pediatric Orthopedic Associates | Past | Accepting new patients | |
| Livara Health Medical Group NJ, PC | Physical Therapist | Past | 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 and National Provider Directory roles.
-
- Physical Therapist
- San Diego, CA
- NPI 1861282691
-
- Physical Therapist
- Del Mar, CA
- NPI 1720517428
-
- Pediatric Radiology Physician
- Salt Lake City, UT
- NPI 1659488799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1508356130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7525 METROPOLITAN DR STE 306",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084404",
"telephone_number": "844-316-7979",
"fax_number": "866-813-1235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7525 METROPOLITAN DR STE 306",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921084404",
"telephone_number": "844-316-7979",
"fax_number": "866-813-1235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALLY",
"first_name": "PAUL",
"middle_name": "MICHAEL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-18",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT013485",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "11752",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT299985",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "299985",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.