Individual provider Active NPI

William Christopher Sir Lyv, PT, DPT

  • Physical Therapist
  • Tustin, CA
National Provider Identifier
1609630656
Registry record updated Jul 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
305571 Issued in CA
Practice address
2492 Walnut Ave Ste 140
Tustin, CA 92780-6953
Phone
(714) 544-2188
Fax
(714) 544-2189
NPI assigned
Feb 9, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 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 305571 CA Primary

Addresses

Primary practice location

2492 Walnut Ave Ste 140
Tustin, CA 92780-6953

Mailing address

2492 Walnut Ave Ste 140
Tustin, CA 92780-6953
Phone (714) 544-2188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312001473 CA Practitioner - Physical Therapist in Private Practice 0345686440 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
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
State-of-the-Art Physical Therapy, Inc.Group PAC ID 5496948952, 10 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

2492 Walnut Ave
Suite 140
Tustin, CA 92780-6953
Phone (714) 544-2188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 14, 2024 Accepting new patients
State-of-the-Art Physical Therapy, Inc. Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

2492 Walnut Ave
Ste 140
Tustin, CA 92780
Phone (714) 544-2188

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722124800000",
    "number": "1609630656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 140",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806953",
            "telephone_number": "714-544-2188",
            "fax_number": "714-544-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2492 WALNUT AVE STE 140",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806953",
            "telephone_number": "714-544-2188",
            "fax_number": "714-544-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYV",
        "first_name": "WILLIAM",
        "middle_name": "CHRISTOPHER SIR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-07-28",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "305571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.