NPIMap

Organization Active NPI

Playa Physical Therapy

  • Physical Therapy Clinic/Center
  • Playa Vista, CA
National Provider Identifier
1598711566
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PLAYA PHYSICAL THERAPY
Doing business as
Playa Physical Therapy
Practice address
13163 Fountain Park Dr
Suite a
Playa Vista, CA 90094-2040
Phone
(310) 823-2220
Fax
(310) 823-2636
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Authorized official

Name
Mr. Aaron Michael Willis, DPTNPI 1003855776
Title
Ceo/Physical Therapist
Phone
(310) 823-2220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

13163 Fountain Park Dr
Suite a
Playa Vista, CA 90094-2040

Mailing address

13163 Fountain Park Dr
Suite a
Playa Vista, CA 90094-2040
Phone (310) 823-2220

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ08931ZOtherCABLUE SHIELD PROVIDER #

Other names 1

  • Playa Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716001137 CA Part B Supplier - Clinic/Group Practice 5496734022 Receives reassigned benefits from 8 practitioners
Practice locations: Playa Vista, CA

National Provider Directory

National Provider Directory

Locations

13315 W Washington Blvd
Ste 302
Los Angeles, CA 90066
Phone (310) 823-2220

13163 Fountain Park Dr
Ste A
Playa Vista, CA 90094
Phone (310) 823-2220

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1598711566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13163 FOUNTAIN PARK DR",
            "address_2": "SUITE A",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942040",
            "telephone_number": "310-823-2220",
            "fax_number": "310-823-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13163 FOUNTAIN PARK DR",
            "address_2": "SUITE A",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942040",
            "telephone_number": "310-823-2220",
            "fax_number": "310-823-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAYA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "310-823-2220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "ZZZ08931Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Playa Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Playa Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.