Michael Brandon Fernandez, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

301638 Issued in CA

Practice address

2600 Pacific Coast Hwy Ste 150
Corona del Mar, CA 92625-2144

Phone

(949) 640-2121

NPI assigned

Feb 25, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Laguna Beach Rehab IncGroup PAC ID 4688686538, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Laguna Beach Rehab, Inc.

  • Clinic/Center
  • Newport Beach, CA
  • NPI 1164466785

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Laguna Beach Rehab Inc

  • Clinic/Center
  • Laguna Beach, CA
  • NPI 1578514832
  NPD

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1679229876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21827 ARBOR CT",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891490",
            "telephone_number": "909-868-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 PACIFIC COAST HWY STE 150",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252144",
            "telephone_number": "949-640-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Elbayar
• Enas Elshiwick, PSY.D.,MFT
• Abby Endres, DC
• Ginger Fee
• Gary Ellis Feldman, M.D.
• William S. Flanagan III, L.AC.
• Laleh Taheri Ford, PHARM.D.
• Brianna Doreen Foreman, PT, DPT
• Emily Forney, FNP-C
• Jeffrey Fracalosy, DPT

• Physical Therapist in Corona del Mar, CA
• Providers in Corona del Mar, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.