Active NPI
Joseph Fernicola
- Physical Therapist
- San Diego, CA
National Provider Identifier
1518535897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 300158
- Practice address
- 8515 Costa Verde Blvd
San Diego, CA 92122-1130 - Phone
- (888) 674-4036
- NPI assigned
- Jun 14, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 300158 | CA | Primary |
Addresses
Primary practice location
8515 Costa Verde Blvd
San Diego, CA 92122-1130
Mailing address
5215 Edgeworth Rd
San Diego, CA 92109-1425
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1518535897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5215 EDGEWORTH RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921091425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8515 COSTA VERDE BLVD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921221130",
"telephone_number": "888-674-4036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNICOLA",
"first_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-14",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "300158",
"primary": true
}
],
"identifiers": [],
"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 Jun 14, 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.