Individual provider Active NPI

Arian Irannejad, PT

  • Physical Therapist
  • Anaheim, CA
National Provider Identifier
1508362401
Registry record updated Apr 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294431 Issued in CA
Practice address
1211 W la Palma Ave Ste 602
Anaheim, CA 92801-2813
Phone
(657) 251-9210
Fax
(657) 202-2711
NPI assigned
Apr 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2018

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 294431 CA Primary

Addresses

Primary practice location

1211 W la Palma Ave Ste 602
Anaheim, CA 92801-2813

Mailing address

1642 Orchard Dr Apt B
Placentia, CA 92870-7423
Phone (858) 539-9761

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606001264 CA Practitioner - Physical Therapist in Private Practice 2567727944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Movement Physical Therapy and PerformanceGroup PAC ID 8022557438, 3 clinicians

Practice addresses (Care Compare)

1450 5TH St
Suite 120
Santa Monica, CA 90401-2579
Phone (858) 539-9761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Movement Physical Therapy & Performance Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients

Locations

1450 5th St
Ste 120
Santa Monica, CA 90401
Phone (858) 539-9761

Organizations & group practices 1

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523059200000",
    "number": "1508362401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 ORCHARD DR APT B",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928707423",
            "telephone_number": "858-539-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 602",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012813",
            "telephone_number": "657-251-9210",
            "fax_number": "657-202-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRANNEJAD",
        "first_name": "ARIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2018-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2018; 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.