Individual provider Active NPI

Nima Enayati, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1578076097
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294009 Issued in CA
Practice address
10447 Roselle St Ste 1
San Diego, CA 92121-1559
Phone
(925) 577-3815
NPI assigned
Nov 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 294009 CA Primary

Addresses

Primary practice location

10447 Roselle St Ste 1
San Diego, CA 92121-1559

Mailing address

10447 Roselle St Ste 1
San Diego, CA 92121-1559
Phone (925) 577-3815

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180306001778 CA Practitioner - Physical Therapist in Private Practice 1951662014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bewell Home Physical Therapy P C CurrentSince Mar 18, 2022 Accepting new patients

Locations

1582 W San Marcos Blvd
Ste 105B
San Marcos, CA 92078
Phone (650) 452-4110

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1578076097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10447 ROSELLE ST STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211559",
            "telephone_number": "925-577-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10447 ROSELLE ST STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211559",
            "telephone_number": "925-577-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENAYATI",
        "first_name": "NIMA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.