Individual provider Active NPI

Edward Ayub, RPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1598823882
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5573 Issued in CA
Practice address
3145 Rosecrans St
#F
San Diego, CA 92110
Phone
(619) 223-7175
Fax
(619) 223-7030
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5573 CA Primary
Physical Therapist 225100000X PT5573A CA

Addresses

Primary practice location

3145 Rosecrans St
#F
San Diego, CA 92110

Mailing address

3145 Rosecrans St
#F
San Diego, CA 92110
Phone (619) 223-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5573CAMDClinical Social Worker
PT5573CAMDPhysical Therapist
PT5573ACAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1598823882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 ROSECRANS ST",
            "address_2": "#F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-223-7175",
            "fax_number": "619-223-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 ROSECRANS ST",
            "address_2": "#F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-223-7175",
            "fax_number": "619-223-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYUB",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT5573",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT5573A",
            "primary": false
        }
    ],
    "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 Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.