Individual provider Active NPI

Brandon Devalk

  • Physical Therapist
  • Thousand Oaks, CA
National Provider Identifier
1609623016
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305870 Issued in CA
Practice address
501 Marin St Ste 205
Thousand Oaks, CA 91360-4266
Phone
(818) 318-2430
NPI assigned
May 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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 305870 CA Primary

Addresses

Primary practice location

501 Marin St Ste 205
Thousand Oaks, CA 91360-4266

Mailing address

406 Wood Ranch Pkwy
Simi Valley, CA 93065-0622
Phone (763) 377-1687

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808003213 CA Practitioner - Physical Therapist in Private Practice 2466999396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bartley Physical Therapy PCGroup PAC ID 9133306723, 12 clinicians

Practice addresses (Care Compare)

2166 N Moorpark Rd
Suite 200
Thousand Oaks, CA 91360-5009
Phone (805) 370-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305870CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Pacific Physical Therapy and Sports Medicine CurrentSince Jul 22, 2024 Accepting new patients
Bartley Physical Therapy PC Physical Therapist CurrentSince Jul 24, 2025 Accepting new patients

Locations

2166 N Moorpark Rd
Ste 200
Thousand Oaks, CA 91360
Phone (805) 370-1020

501 Marin St
Ste 205
Thousand Oaks, CA 91360
Phone (805) 495-3937

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1609623016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 WOOD RANCH PKWY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650622",
            "telephone_number": "763-377-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MARIN ST STE 205",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604266",
            "telephone_number": "818-318-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVALK",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.