Individual provider Active NPI

Rujuta P Shah

  • Physical Therapist
  • Corona, CA
National Provider Identifier
1679922785
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42209 Issued in CA
Practice address
1561 E Ontario Ave Ste 101
Corona, CA 92881-6663
Phone
(951) 407-2933
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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 25066 MD
Physical Therapist 225100000X 42209 CA Primary

Addresses

Primary practice location

1561 E Ontario Ave Ste 101
Corona, CA 92881-6663

Mailing address

1 Peters Canyon Rd Ste 120
Irvine, CA 92606-1748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171009000716 CA Practitioner - Physical Therapist in Private Practice 3971895855 Reassigns benefits to 2 organizations

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
Fairbanks and Power Physical Therapy CorpGroup PAC ID 6406843481, 53 clinicians

Practice addresses (Care Compare)

25285 Madison Ave
Suite 103
Murrieta, CA 92562-8955
Phone (951) 600-0054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25066MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Spine Restoration Center, Inc Physical Therapist CurrentSince Sep 28, 2017 Accepting new patients
Fairbanks & Power Physical Therapy Corp. Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

1875 California Ave
Corona, CA 92881
Phone (951) 407-9233

1561 E Ontario Ave
Ste 101
Corona, CA 92881
Phone (951) 407-2933

949 S State St
Hemet, CA 92543
Phone (951) 929-9890

2 Peters Canyon Rd
Ste 100
Irvine, CA 92606
Phone (949) 679-3988

1 Peters Canyon Rd
Ste 120
Irvine, CA 92606
Phone (949) 653-6777

25285 Madison Ave
Ste 103
Murrieta, CA 92562
Phone (909) 600-2990

6177 River Crest Dr
Ste A
Riverside, CA 92507
Phone (951) 653-4480

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1679922785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PETERS CANYON RD STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 E ONTARIO AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928816663",
            "telephone_number": "951-407-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RUJUTA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25066",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.