Individual provider Active NPI

Eliza Marie Guillinta, R.P.T

  • Specialist
  • Newhall, CA
National Provider Identifier
1659493203
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
28880 Lyons Ave Suite 100
New Hall, CA 91307-2005
Phone
(661) 290-2884
Fax
(818) 346-5948
NPI assigned
Apr 4, 2007
Last updated
Aug 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

28880 Lyons Ave Suite 100
New Hall, CA 91307-2005

Mailing address

27024 Wolf Creek TRL Unit 21
Valencia, CA 91354-2664
Phone (310) 415-5212

Other identifiers 1

IdentifierTypeStateIssuer
PT27900OtherCAPHYSICAL THERAPIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090730000398 CA Practitioner - Physical Therapist in Private Practice 8921151481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bandb Physical Therapy, IncGroup PAC ID 4486623402, 4 clinicians

Practice addresses (Care Compare)

24355 Lyons Ave
Suite 100
Newhall, CA 91321-2332
Phone (661) 290-2884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT Dynamics & Sports Medicine Inc PastSince Jul 1, 2004 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1659493203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27024 WOLF CREEK TRL UNIT 21",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913542664",
            "telephone_number": "310-415-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28880 LYONS AVE SUITE 100",
            "city": "NEW HALL",
            "state": "CA",
            "postal_code": "913072005",
            "telephone_number": "661-290-2884",
            "fax_number": "818-346-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLINTA",
        "first_name": "ELIZA",
        "middle_name": "MARIE",
        "credential": "R.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "PT27900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.