Individual provider Active NPI

Bailey Joy Iwasa, DPT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Folsom, CA
National Provider Identifier
1609356187
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
295294 Issued in CA
Practice address
691 E Bidwell St
Folsom, CA 95630-3120
Phone
(916) 572-6162
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 295294 CA Primary

Addresses

Primary practice location

691 E Bidwell St
Folsom, CA 95630-3120

Mailing address

691 E Bidwell St
Folsom, CA 95630-3120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128002991 CA Practitioner - Physical Therapist in Private Practice 9032453238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mac Performance Physical Therapy IncGroup PAC ID 7810365608, 15 clinicians

Practice addresses (Care Compare)

691 E Bidwell St
Folsom, CA 95630-3120
Phone (916) 572-6162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mac Performance Physical Therapy Inc CurrentSince Jan 8, 2024 Accepting new patients
Burger Physical Therapy and Rehabilitation Agency Inc Past Accepting new patients

Locations

691 E Bidwell St
Folsom, CA 95630
Phone (916) 572-6162

3727 Bradview Dr
Ste 90
Sacramento, CA 95827

3727 Bradview Dr
Ste 100
Sacramento, CA 95827
Phone (916) 572-6162

Organizations & group practices 2

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1609356187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 E BIDWELL ST",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303120",
            "telephone_number": "916-572-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWASA",
        "first_name": "BAILEY",
        "middle_name": "JOY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "295294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.