Organization Active NPI

Recovercare Therapy Group, Inc.

  • Physical Therapist
  • Buena Park, CA
National Provider Identifier
1508802471
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RECOVERCARE THERAPY GROUP, INC.
Practice address
6850 Lincoln Ave Ste 205
Buena Park, CA 90620-4178
Phone
(714) 527-9240
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Marilou Bollier, PT
Title
Director of Rehab
Phone
(562) 484-3860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

6850 Lincoln Ave Ste 205
Buena Park, CA 90620-4178

Mailing address

13330 Bloomfield Ave
Suite 101
Norwalk, CA 90650-3251

Other identifiers 1

IdentifierTypeStateIssuer
W15262AOtherCAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000896 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9133023443 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buena Park, CA; Norwalk, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Active Sports Rehab and Wellness Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

555 N State College Blvd
Ste 100
Anaheim, CA 92806
Phone (714) 254-0500

8615 Knott Ave
Ste 8
Buena Park, CA 90620
Phone (562) 484-3860

6850 Lincoln Ave
Ste 205
Buena Park, CA 90620
Phone (714) 527-9240

1051 Bryan Ave
#12
Tustin, CA 92780
Phone (714) 544-4066

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1508802471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13330 BLOOMFIELD AVE",
            "address_2": "SUITE 101",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 LINCOLN AVE STE 205",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906204178",
            "telephone_number": "714-527-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERCARE THERAPY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "BOLLIER",
        "authorized_official_first_name": "MARILOU",
        "authorized_official_title_or_position": "DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "562-484-3860",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W15262A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.