Individual provider Active NPI

Margaret Komrij

  • Physical Therapy Assistant
  • Orange, CA
National Provider Identifier
1649669292
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT 4064 Issued in CA
Practice address
1835 W la Veta Ave
Orange, CA 92868-4132
Phone
(714) 978-6800
NPI assigned
Jan 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT 4064 CA Primary

Addresses

Primary practice location

1835 W la Veta Ave
Orange, CA 92868-4132

Mailing address

11114 Bermuda St
Cerritos, CA 90703-1639
Phone (714) 294-4098

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT 4064CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1649669292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11114 BERMUDA ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031639",
            "telephone_number": "714-294-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684132",
            "telephone_number": "714-978-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMRIJ",
        "first_name": "MARGARET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT 4064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.