Individual provider Active NPI

Sivan Eckert

  • Physical Therapist
  • Fountain Valley, CA
National Provider Identifier
1689366700
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304085 Issued in CA
Practice address
18785 Brookhurst St Ste 104
Fountain Valley, CA 92708-7300
Phone
(657) 301-4967
NPI assigned
May 25, 2023
Last updated
May 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 304085 CA Primary

Addresses

Primary practice location

18785 Brookhurst St Ste 104
Fountain Valley, CA 92708-7300

Mailing address

18785 Brookhurst St Ste 104
Fountain Valley, CA 92708-7300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705001737 CA Practitioner - Physical Therapist in Private Practice 2769841063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18785 Brookhurst St
Suite 104
Fountain Valley, CA 92708-7300
Phone (657) 301-4967

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
304085CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Rehabilitation & Sports Therapy a California Physical Ther Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
California Rehab & Sports Therapy CurrentSince Jun 12, 2023 Accepting new patients

Locations

505 N Euclid St
Ste 680
Anaheim, CA 92801
Phone (714) 780-0010

2035 Corte del Nogal
Ste 200
Carlsbad, CA 92011
Phone (760) 931-8310

4755 Katella Ave
Ste 101
Cypress, CA 90720
Phone (657) 213-8687

11420 Warner Ave
Ste B
Fountain Valley, CA 92708
Phone (657) 204-2959

18785 Brookhurst St
Ste 104
Fountain Valley, CA 92708
Phone (657) 301-4967

18682 Beach Blvd
Ste 160
Huntington Beach, CA 92648
Phone (714) 378-1300

7071 Warner Ave
Ste A
Huntington Beach, CA 92647
Phone (714) 847-3800

Organizations & group practices 2

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1689366700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18785 BROOKHURST ST STE 104",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18785 BROOKHURST ST STE 104",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087300",
            "telephone_number": "657-301-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "SIVAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.