Individual provider Active NPI

Tracey Bingham, DPT

  • Physical Therapist
  • Laguna Niguel, CA
National Provider Identifier
1659026045
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301761 Issued in CA
Practice address
30100 Town Center Dr Ste Yz
Laguna Niguel, CA 92677-2064
Phone
(949) 276-5401
Fax
(949) 276-5403
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 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 301761 CA Primary

Addresses

Primary practice location

30100 Town Center Dr Ste Yz
Laguna Niguel, CA 92677-2064

Mailing address

30100 Town Center Dr Ste Yz
Laguna Niguel, CA 92677-2064
Phone (949) 276-5401

Other names 1

  • Tracey Vogt Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220602000418 CA Practitioner - Physical Therapist in Private Practice 4688052715 Reassigns benefits to 2 organizations

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
Proresults Physical Therapy IncGroup PAC ID 8022364538, 30 clinicians

Practice addresses (Care Compare)

12639 Poway Rd
Poway, CA 92064-4415
Phone (858) 883-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301761CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proresults Physical Therapy Inc. Physical Therapist CurrentSince Dec 22, 2024 Accepting new patients
Pack Physical Therapy, Inc. Physical Therapist PastSince Jul 1, 2012 Accepting new patients

Locations

12639 Poway Rd
Poway, CA 92064
Phone (858) 294-1897

137 S Las Posas Rd
Ste 254
San Marcos, CA 92078
Phone (760) 290-3121

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1659026045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DR STE YZ",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772064",
            "telephone_number": "949-276-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30100 TOWN CENTER DR STE YZ",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926772064",
            "telephone_number": "949-276-5401",
            "fax_number": "949-276-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "TRACEY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "VOGT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.