Individual provider Active NPI

Dustin Corey Hancock, DPT

  • Physical Therapist
  • San Juan Capistrano, CA
National Provider Identifier
1659645604
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38772 Issued in CA
Practice address
31896 Plaza Dr Ste E3
San Juan Capistrano, CA 92675-3724
Phone
(949) 312-2485
Fax
(949) 312-2856
NPI assigned
Mar 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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 38772 CA Primary

Addresses

Primary practice location

31896 Plaza Dr Ste E3
San Juan Capistrano, CA 92675-3724

Mailing address

31878 Del Obispo St Ste 118-426
San Juan Capistrano, CA 92675-3223
Phone (949) 298-5403

Other practice location 1

25971 Pala Ste 110
Mission Viejo, CA 92691-2742
Phone (949) 465-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120807000226 CA Practitioner - Physical Therapist in Private Practice 6002062064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Define Wellness and Physical Therapy IncGroup PAC ID 5890186936, 3 clinicians

Practice addresses (Care Compare)

31896 Plaza Dr
Suite E3
San Juan Capistrano, CA 92675-3724
Phone (949) 312-2485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38772CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Define Wellness and Physical Therapy Inc Physical Therapist CurrentSince Sep 23, 2019 Accepting new patients
Rausch Physical Therapy, Inc. Physical Therapist PastSince Mar 15, 2006 Accepting new patients
Deborah Weinstein Physical Therapy Physical Therapist PastSince Oct 30, 2011 Accepting new patients
Balance Rehabilitation, Inc. Physical Therapist PastSince Mar 1, 2015 Accepting new patients

Locations

31896 Plaza Dr
Ste E3
San Juan Capistrano, CA 92675
Phone (949) 312-2485

31878 Del Obispo St
Ste 118426
San Juan Capistrano, CA 92675

Organizations & group practices 4

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": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1659645604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31878 DEL OBISPO ST STE 118-426",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753223",
            "telephone_number": "949-298-5403",
            "fax_number": "949-312-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31896 PLAZA DR STE E3",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753724",
            "telephone_number": "949-312-2485",
            "fax_number": "949-312-2856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25971 Pala Ste 110",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926912742",
            "country_code": "US",
            "telephone_number": "949-465-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "DUSTIN",
        "middle_name": "COREY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-07",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "38772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.