Individual provider Active NPI

Jason Taresh, DPT

  • Physical Therapist
  • Chula Vista, CA
National Provider Identifier
1639886534
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299786 Issued in CA
Practice address
821 Kuhn Dr Ste 107
Chula Vista, CA 91914-4508
Phone
(619) 397-1391
NPI assigned
Oct 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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 299786 CA Primary

Addresses

Primary practice location

821 Kuhn Dr Ste 107
Chula Vista, CA 91914-4508

Mailing address

821 Kuhn Dr Ste 107
Chula Vista, CA 91914-4508
Phone (619) 397-1391

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613000322 CA Practitioner - Physical Therapist in Private Practice 6709328164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vandl Ventures Physical Therapy IncGroup PAC ID 5092627174, 3 clinicians

Practice addresses (Care Compare)

1044 Mangrove Ave
Chico, CA 95926-3509
Phone (530) 892-2966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299786CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Performance Physical Therapy Inc CurrentSince Nov 6, 2022 Accepting new patients
V&L Ventures Physical Therapy, Inc Physical Therapist CurrentSince May 29, 2024 Accepting new patients

Locations

1044 Mangrove Ave
Chico, CA 95926
Phone (530) 343-1908

821 Kuhn Dr
Ste 107
Chula Vista, CA 91914
Phone (619) 397-1391

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": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1639886534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 KUHN DR STE 107",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144508",
            "telephone_number": "619-397-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 KUHN DR STE 107",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144508",
            "telephone_number": "619-397-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARESH",
        "first_name": "JASON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.