Individual provider Active NPI

Jessie Le, DPT

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1528655925
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299207 Issued in CA
Practice address
534 E Pine St Ste a
Stockton, CA 95204-5536
Phone
(209) 463-5800
Fax
(209) 463-5900
NPI assigned
Dec 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 299207 CA Primary

Addresses

Primary practice location

534 E Pine St Ste a
Stockton, CA 95204-5536

Mailing address

534 E Pine St Ste a
Stockton, CA 95204-5536
Phone (209) 463-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210129001798 CA Practitioner - Physical Therapist in Private Practice 6103230313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doskalchuk Physical Therapy CorporationGroup PAC ID 8022347780, 3 clinicians

Practice addresses (Care Compare)

5120 Manzanita Ave
Suite 110
Carmichael, CA 95608-0590
Phone (916) 926-0496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299207CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Doskalchuk Physical Therapy Corporation Physical Therapist CurrentSince Aug 29, 2022 Accepting new patients

Locations

5120 Manzanita Ave
Ste 110
Carmichael, CA 95608
Phone (916) 482-2200

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": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1528655925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 E PINE ST STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045536",
            "telephone_number": "209-463-5800",
            "fax_number": "209-463-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 E PINE ST STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045536",
            "telephone_number": "209-463-5800",
            "fax_number": "209-463-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "JESSIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; 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.