Beckett Charles Gandolfi, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

15 Corporate Plaza Dr
Newport Beach, CA 92660-7918

Phone

(949) 759-1840

NPI assigned

Sep 10, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Reischl Physical Therapy IncGroup PAC ID 6709825219, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Reischl Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Signal Hill, CA
  • NPI 1861412645

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Core Performance Physical Therapy, Inc.

  • Orthopedic Physical Therapist
  • Newport Beach, CA
  • NPI 1871878041

  Single Specialty

  Medicare reassignment NPD
• Marina Sports Physical Therapy P C

  • Physical Therapist
  • Rancho Palos Verdes, CA
  • NPI 1225522725
  Medicare reassignment
• Navy Physical Therapy P.C.

  • Physical Therapist
  • Van Nuys, CA
  • NPI 1881392223

  Single Specialty

  NPD

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1558030726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 NEWPORT AVE UNIT 303",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908148103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORPORATE PLAZA DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607918",
            "telephone_number": "949-759-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOLFI",
        "first_name": "BECKETT",
        "middle_name": "CHARLES",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gamma Neuro Diagnostics Inc
• Faziela Gandara, NP
• Meliza Maria Gandara, LCSW
• Michelle Gandawidjaja
• Radhakrishan S Gandhi, M.D.
• Raeika Ganji
• Avro Gaon, MD
• Lisa D. Garbutt, M.D.
• Priscila Garcia Bedolla
• Cristina Garcia Hernandez

• Physical Therapist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.