Nandi Sundaram, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29433 Issued in CA

Practice address

2492 Walnut Ave Ste 140
Tustin, CA 92780-6953

Phone

(714) 544-2188

Fax

(714) 544-2189

NPI assigned

Oct 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairbanks and Power Physical Therapy CorpGroup PAC ID 6406843481, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bodydynamixintegrartedsportsmedicind.nandidevasundaram@139089.advancedmd-direct.com

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.

• Fairbanks & Power Physical Therapy Corp.

  dba PacificPro Physical Therapy & Sports Medicine

  • Physical Therapist
  • Irvine, CA
  • NPI 1912953936
  Medicare reassignment Care Compare group NPD
• State-of-the-Art Physical Therapy, Inc.

  • Physical Therapist
  • Tustin, CA
  • NPI 1437179959
  Medicare reassignment
• Impt, Inc.

  dba In Motion Physical Therapy

  • Orthopedic Physical Therapist
  • Irvine, CA
  • NPI 1184670804
  NPD (past)

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1568650794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 140",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806953",
            "telephone_number": "714-544-2188",
            "fax_number": "714-544-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 140",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806953",
            "telephone_number": "714-544-2188",
            "fax_number": "714-544-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "NANDI",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-12",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT29433",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT29433",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chizuru Maruyama Sukauskas
• Summit Acupuncture & Herbs
• Summit Acupuncture & Herbs
• Sun Jiaqi DDS, Inc.
• Ning Sun, FNP-BC
• Levana Sung
• Okbae Sung
• Super Care, LLC (SuperCare Health)
• Jennifer Rachael Surgener, FNP
• Suryah Habibi, DMD, Inc

• Physical Therapist in Tustin, CA
• Providers in Tustin, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.