Angela Maccollam, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50786 Issued in CA

Practice address

3861 Mission Ave Ste B25
Oceanside, CA 92058-1817

Phone

(760) 655-1322

NPI assigned

Nov 3, 2020

Last updated

Nov 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Oceanside Physical Therapy P C

  • Physical Therapist
  • Oceanside, CA
  • NPI 1437625217
  NPD

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1528669876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 RIO WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816317",
            "telephone_number": "760-707-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 MISSION AVE STE B25",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581817",
            "telephone_number": "760-655-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCOLLAM",
        "first_name": "ANGELA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean-Michael Lyons
• Alexander Lytle, PT, DPT
• Gene Ma, M.D.
• Victor Mac, DO
• Joseph Paul Macaluso, PHARMACIST
• Preston Macdonald, DDS
• Ivan Macias
• Colleen Maciel, NP
• Elizabeth Trescot Macintyre, M.D.
• Lisa Mackey, RN, BSN, PHN

• Physical Therapy Assistant in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.