Individual provider Active NPI

Joseph John Donohue, PT

  • Physical Therapist
  • Costa Mesa, CA
National Provider Identifier
1619930252
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13681 Issued in CA
Practice address
2777 Bristol St
Ste B
Costa Mesa, CA 92626-5997
Phone
(949) 250-1112
Fax
(949) 250-1401
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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 13681 CA Primary

Addresses

Primary practice location

2777 Bristol St
Ste B
Costa Mesa, CA 92626-5997

Mailing address

2777 Bristol St
Ste B
Costa Mesa, CA 92626-5997
Phone (949) 250-1112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229000560 CA Practitioner - Physical Therapist in Private Practice 6406843465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Mar 13, 2020 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince Mar 13, 2020 Accepting new patients
Evolve Integrated Wellness and Physical Therapy PC Physical Therapist Past Accepting new patients
Prosport Physical Therapy Professionals Inc PastSince Sep 25, 2015 Accepting new patients

Locations

2777 Bristol St
Ste B
Costa Mesa, CA 92626
Phone (949) 250-1112

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

23001 Del Lago Dr
Ste C1
Laguna Hills, CA 92653
Phone (949) 387-7331

Organizations & group practices 4

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1619930252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 BRISTOL ST",
            "address_2": "STE B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265997",
            "telephone_number": "949-250-1112",
            "fax_number": "949-250-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 BRISTOL ST",
            "address_2": "STE B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265997",
            "telephone_number": "949-250-1112",
            "fax_number": "949-250-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHUE",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "13681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.