Misi Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MISI PHYSICAL THERAPY, PC

Practice address

555 N Nash St
El Segundo, CA 90245-2818

Phone

(310) 386-6788

NPI assigned

Jan 31, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Brett William Bloom, PT, DPTNPI 1790881639

Title

Cfo

Phone

(310) 386-6788

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brett W Bloom

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1790881639
  NPD Authorized official
• Tanner McCloud Roche, PT, DPT

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1710763289
  NPD (past)
• Casey Waller, PT, DPT

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1659926301
  NPD (past)
• Lisa Rosen

  • Physical Therapist
  • Windham, ME
  • NPI 1669149167
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1629784848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 N EL CAMINO REAL # B-351",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241334",
            "telephone_number": "310-386-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NASH ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452818",
            "telephone_number": "310-386-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISI PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-386-6788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA PHYSICAL THERAPY BOARD",
            "identifier": "26571",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Miranda
• Nichole Miranda
• Salma A. Mire
• Lia Mirzakhanian
• Aishwarya Mishra
• Jessica L. Misiti, ARNP
• Marcell Mitchell-Hicks
• Alex Mitchell
• Evelyn Mitchell
• Kandi Mitchell

• Physical Therapist in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.