Individual provider Active NPI

Chelsea Eden Rendahl, P.T., D.P.T.

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1518468487
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT294450 Issued in CA
Practice address
1922 Hacienda Dr
Vista, CA 92081-6024
Phone
(760) 295-4175
Fax
(760) 295-4176
NPI assigned
Feb 26, 2018
Last updated
Feb 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 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 PT294450 CA Primary

Addresses

Primary practice location

1922 Hacienda Dr
Vista, CA 92081-6024

Mailing address

13496 Russet Leaf LN
San Diego, CA 92129-4410
Phone (858) 805-5516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180302001867 CA Practitioner - Physical Therapist in Private Practice 9638430895 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
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

1338 Main St
Ramona, CA 92065-2127
Phone (760) 789-1400

1922 Hacienda Dr
Vista, CA 92081-6024
Phone (760) 295-4175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT294450CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All Star Physical Therapy Physical Therapist CurrentSince Feb 28, 2018 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist PastSince Feb 28, 2018 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

1922 Hacienda Dr
Vista, CA 92081
Phone (760) 295-4175

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1518468487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13496 RUSSET LEAF LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921294410",
            "telephone_number": "858-805-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816024",
            "telephone_number": "760-295-4175",
            "fax_number": "760-295-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDAHL",
        "first_name": "CHELSEA",
        "middle_name": "EDEN",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT294450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

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