Individual provider Active NPI

Rafael Uribe

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1568278679
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307342 Issued in CA
Practice address
10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943
Phone
(310) 286-0447
NPI assigned
Dec 4, 2024
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 307342 CA Primary

Addresses

Primary practice location

10351 Santa Monica Blvd Ste 101
Los Angeles, CA 90025-6943

Mailing address

1415 Peg PL Apt 105
Los Angeles, CA 90035-2827
Phone (773) 416-9587

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212000869 CA Practitioner - Physical Therapist in Private Practice 4284164872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paulseth and Associates Physical Therapy IncGroup PAC ID 9638074073, 5 clinicians

Practice addresses (Care Compare)

10351 Santa Monica Blvd
Suite 101
Los Angeles, CA 90025-6943
Phone (310) 286-0447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
307342CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist Current Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients
Paulseth and Associates Physical Therapy Inc. Physical Therapist CurrentSince Dec 16, 2024 Accepting new patients

Locations

559 E Carson St
Ste B
Carson, CA 90745
Phone (424) 201-5242

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

10351 Santa Monica Blvd
Ste 101
Los Angeles, CA 90025
Phone (310) 286-0447

Organizations & group practices 4

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": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1568278679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 PEG PL APT 105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900352827",
            "telephone_number": "773-416-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 SANTA MONICA BLVD STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256943",
            "telephone_number": "310-286-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URIBE",
        "first_name": "RAFAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.