Individual provider Active NPI

Victor DO

  • Physical Therapist
  • Santa Ana, CA
National Provider Identifier
1689156838
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295180 Issued in CA
Practice address
2700 N Main St Ste 150
Santa Ana, CA 92705-6638
Phone
(844) 316-7979
NPI assigned
Sep 4, 2018
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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 PT295180 CA Primary

Addresses

Primary practice location

2700 N Main St Ste 150
Santa Ana, CA 92705-6638

Mailing address

16076 Rue Cir
Fountain Valley, CA 92708-1533
Phone (626) 726-5209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181012001495 CA Practitioner - Physical Therapist in Private Practice 4688926074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians
Livara Health Medical Group PCGroup PAC ID 8022238872, 23 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

7525 Metropolitan Dr
Suite 306
San Diego, CA 92108-4404
Phone (844) 316-7979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT295180CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Livara Health Medical Group PC Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist PastSince Nov 3, 2019 Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist PastSince Feb 25, 2024 Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist Past Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist PastSince Jul 7, 2024 Accepting new patients
Spinezone Medical Fitness, Inc. Physical Therapist Past Accepting new patients
Livara Health Medical Group NJ, PC Physical Therapist Past Accepting new patients

Locations

12865 Pointe del Mar Way
Ste 190
Del Mar, CA 92014
Phone (619) 432-4634

23161 Lake Center Dr
Ste 120
Lake Forest, CA 92630

1828 Oceanside Blvd
Oceanside, CA 92054

2535 Camino del Rio S
Ste 150
San Diego, CA 92108
Phone (619) 294-2550

7525 Metropolitan Dr
Ste 306
San Diego, CA 92108
Phone (619) 275-7460

2700 N Main St
Ste 150
Santa Ana, CA 92705
Phone (619) 432-4634

400 N Tustin Ave
Ste 140
Santa Ana, CA 92705

Interoperability endpoints

  • Direct secure messaging: victor.do.1@11199.direct.athenahealth.com

Organizations & group practices 8

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1689156838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16076 RUE CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927081533",
            "telephone_number": "626-726-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N MAIN ST STE 150",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056638",
            "telephone_number": "844-316-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "VICTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.