Individual provider Active NPI

Warren R Q Comstock, MPT

  • Physical Therapist
  • Lake Forest, CA
National Provider Identifier
1659424208
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24606 Issued in CA
Practice address
23832 Rockfield Blvd Ste 160
Lake Forest, CA 92630-2820
Phone
(949) 465-9500
Fax
(949) 465-9506
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X MPT24606 CA
Physical Therapist 225100000X PT24606 CA Primary

Addresses

Primary practice location

23832 Rockfield Blvd Ste 160
Lake Forest, CA 92630-2820

Mailing address

23832 Rockfield Blvd Ste 160
Lake Forest, CA 92630-2820
Phone (949) 465-9500

Other identifiers 1

IdentifierTypeStateIssuer
PT24606OtherCAPT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080721000743 CA Practitioner - Physical Therapist in Private Practice 6103999370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salus Home Health and Hospice IncGroup PAC ID 3971680398, 4 clinicians

Practice addresses (Care Compare)

630 Roosevelt
Suite a
Irvine, CA 92620-3621
Phone (888) 725-8742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24606CAMDDentist
MPT24606CAMDPhysical Therapist
PT24606CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Management Inc CurrentSince Apr 23, 2018 Accepting new patients
H2Orthopedic Physical Therapy Inc Physical Therapist CurrentSince May 1, 2024 Accepting new patients

Locations

12465 Lewis St
Ste 101
Garden Grove, CA 92840
Phone (714) 703-8477

23961 Calle de la Magdalena
Ste 119
Laguna Hills, CA 92653
Phone (949) 595-8635

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1659424208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 160",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302820",
            "telephone_number": "949-465-9500",
            "fax_number": "949-465-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 160",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302820",
            "telephone_number": "949-465-9500",
            "fax_number": "949-465-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMSTOCK",
        "first_name": "WARREN",
        "middle_name": "R Q",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "MPT24606",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT24606",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.