Individual provider Active NPI

Leslie Jean Dykstra-Ordanes, P.T.

  • Physical Therapist
  • Los Alamitos, CA
National Provider Identifier
1528304698
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21523 Issued in CA
Practice address
5122 Katella Ave Ste 16
Los Alamitos, CA 90720-2838
Phone
(562) 795-5295
NPI assigned
Dec 18, 2012
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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 PT21523 CA Primary

Addresses

Primary practice location

5122 Katella Ave Ste 16
Los Alamitos, CA 90720-2838

Mailing address

5530 E Hanbury St
Long Beach, CA 90808-2005
Phone (562) 682-1884

Other practice location 1

9470 Firestone Blvd.
Downey, CA 90241
Phone (562) 401-4094

Other names 1

  • Ms. Leslie Jean Dykstra Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131127001723 CA Practitioner - Physical Therapist in Private Practice 6406082114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JRD Physical Therapy IncGroup PAC ID 9931480787, 5 clinicians

Practice addresses (Care Compare)

4220 Katella Ave
Los Alamitos, CA 90720-3511
Phone (562) 342-9994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT21523CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
JRD Physical Therapy Inc Physical Therapist CurrentSince May 17, 2021 Accepting new patients
Nifty After Fifty Physical Therapist Past Accepting new patients
Alamitos Physical Therapy Physical Therapist PastSince Jan 21, 2021 Accepting new patients
Trinh M Doan, Inc. Physical Therapist Past Accepting new patients
Naf Physical Therapy Inc Physical Therapist Past Accepting new patients

Locations

4220 Katella Ave
Los Alamitos, CA 90720
Phone (562) 342-9994

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1528304698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 E HANBURY ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082005",
            "telephone_number": "562-682-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 KATELLA AVE STE 16",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202838",
            "telephone_number": "562-795-5295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9470 Firestone Blvd.",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "90241",
            "country_code": "US",
            "telephone_number": "562-401-4094",
            "fax_number": "562-803-9423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKSTRA-ORDANES",
        "first_name": "LESLIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT21523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "DYKSTRA",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.