Individual provider Active NPI

Tomislav Andro Simunovic, R.P.T

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1629144472
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12688 Issued in CA
Practice address
2140 W Olympic Blvd
S. 301
Los Angeles, CA 90006-2206
Phone
(213) 383-0191
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT12688 CA Primary

Addresses

Primary practice location

2140 W Olympic Blvd
S. 301
Los Angeles, CA 90006-2206

Mailing address

1341 Brookdale Ave
La Habra, CA 90631-3221
Phone (562) 818-2974

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
PT12688CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Koa Rehab & Physical Therapy Center, Inc Physical Therapist Past Accepting new patients
Sonshine Rehab & Physical Therapy Center, a Professional Corporation Physical Therapist Past Accepting new patients
Garfield Holistic Medical Group Past Accepting new patients

Organizations & group practices 3

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629144472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 BROOKDALE AVE",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313221",
            "telephone_number": "562-818-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W OLYMPIC BLVD",
            "address_2": "S. 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062206",
            "telephone_number": "213-383-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMUNOVIC",
        "first_name": "TOMISLAV",
        "middle_name": "ANDRO",
        "credential": "R.P.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.