NPIMap

Organization Active NPI

Physical Therapy Effect PC

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1659703502
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
36879 Issued in CA
Legal business name
PHYSICAL THERAPY EFFECT PC
Practice address
1601 Kettner Blvd
Suite 11
San Diego, CA 92101-2500
Phone
(619) 544-1055
Fax
(619) 544-1056
NPI assigned
Aug 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Dr. Mark Andrew Shulman, DPTNPI 1477865848
Title
Owner/Ceo
Phone
(619) 544-1055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 36879 CA Primary

Addresses

Primary practice location

1601 Kettner Blvd
Suite 11
San Diego, CA 92101-2500

Mailing address

1601 Kettner Blvd
Suite 11
San Diego, CA 92101-2500
Phone (619) 544-1055

Other practice location 1

1 Creekside Dr Unit 100
San Marcos, CA 92078-2351
Phone (619) 544-1055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131203000150 CA Part B Supplier - Clinic/Group Practice 4385870062 Receives reassigned benefits from 9 practitioners
Practice locations: San Diego, CA; San Marcos, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1659703502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 KETTNER BLVD",
            "address_2": "SUITE 11",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012500",
            "telephone_number": "619-544-1055",
            "fax_number": "619-544-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 KETTNER BLVD",
            "address_2": "SUITE 11",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012500",
            "telephone_number": "619-544-1055",
            "fax_number": "619-544-1056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Creekside Dr Unit 100",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "CA",
            "postal_code": "920782351",
            "country_code": "US",
            "telephone_number": "619-544-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICAL THERAPY EFFECT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "SHULMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "619-544-1055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "36879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.