NPIMap

Organization Active NPI

Santa Maria Valley Physical Therapy Group, Inc.

  • Physical Therapist
  • Santa Maria, CA
National Provider Identifier
1548260367
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SANTA MARIA VALLEY PHYSICAL THERAPY GROUP, INC.
Practice address
820 E Enos Dr
Santa Maria, CA 93454
Phone
(805) 928-8257
Fax
(805) 349-7206
NPI assigned
Jul 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Ms. Laura C. Fylstra
Title
Office Manager
Phone
(805) 928-8257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

820 E Enos Dr
Santa Maria, CA 93454

Mailing address

820 E Enos Dr
Santa Maria, CA 93454
Phone (805) 928-8257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041214000538 CA Part B Supplier - Clinic/Group Practice 3173580925 Receives reassigned benefits from 8 practitioners
Practice locations: Santa Maria, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1548260367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E ENOS DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-928-8257",
            "fax_number": "805-349-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E ENOS DR",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-928-8257",
            "fax_number": "805-349-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MARIA VALLEY PHYSICAL THERAPY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "FYLSTRA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-928-8257",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.