Individual provider Active NPI

Tanner Ravize, DPT

  • Orthopedic Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1538939236
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
304837 Issued in CA
Practice address
1600 Dove St Ste 100
Newport Beach, CA 92660-2438
Phone
(949) 502-3388
Fax
(949) 502-3304
NPI assigned
Jan 3, 2024
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 304837 CA Primary

Addresses

Primary practice location

1600 Dove St Ste 100
Newport Beach, CA 92660-2438

Mailing address

1600 Dove St Ste 100
Newport Beach, CA 92660-2438
Phone (949) 502-3388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305002058 CA Practitioner - Physical Therapist in Private Practice 4981049525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Accelerate Physical Therapy PCGroup PAC ID 3577816008, 8 clinicians

Practice addresses (Care Compare)

1600 Dove St
Suite 100
Newport Beach, CA 92660-2438
Phone (949) 502-3388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Accelerate Physical Therapy, PC Orthopedic CurrentSince Dec 18, 2023 Accepting new patients
California Luna Care Physical Therapy PC Orthopedic CurrentSince Jan 30, 2026 Accepting new patients
Dugan Therapy and Fitness Inc Orthopedic PastSince Mar 6, 2023 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

1600 Dove St
Ste 100
Newport Beach, CA 92660
Phone (949) 502-3388

2029 Village Ln
Ste 106
Solvang, CA 93463
Phone (805) 686-1934

Organizations & group practices 3

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": "1704240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1538939236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602438",
            "telephone_number": "949-502-3388",
            "fax_number": "949-502-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602438",
            "telephone_number": "949-502-3388",
            "fax_number": "949-502-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIZE",
        "first_name": "TANNER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "304837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.