Individual provider Active NPI

Andreas Schenk

  • Physical Therapist
  • Coronado, CA
National Provider Identifier
1689601775
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT17427 Issued in CA
Practice address
1224 10TH St
Suite 204
Coronado, CA 92118-3416
Phone
(619) 437-6450
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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 PT17427 CA Primary

Addresses

Primary practice location

1224 10TH St
Suite 204
Coronado, CA 92118-3416

Mailing address

1224 10TH St
Suite 204
Coronado, CA 92118-3416
Phone (619) 437-6450

Other identifiers 2

IdentifierTypeStateIssuer
WPT17427BOtherCAMCARE IND PROV # EASTLAKE
WPT17427COtherCAMCARE IND PROV # CORONADO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060818000552 CA Practitioner - Physical Therapist in Private Practice 6406859123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1224 10TH St
Suite 204
Coronado, CA 92118-3420
Phone (619) 437-6450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17427CAMDAddiction (Substance Use Disorder) Counselor
PT17427CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Results Rehabilitation, Inc. Physical Therapist CurrentSince Dec 1, 1999 Accepting new patients
Results Rehabilitation Inc Physical Therapist PastSince Aug 1, 2006 Accepting new patients
Results Rehab Eastlake, Inc. Physical Therapist PastSince Oct 15, 2004 Accepting new patients

Locations

1224 10th St
Ste 204
Coronado, CA 92118
Phone (619) 437-6450

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1689601775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 10TH ST",
            "address_2": "SUITE 204",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183416",
            "telephone_number": "619-437-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 10TH ST",
            "address_2": "SUITE 204",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921183416",
            "telephone_number": "619-437-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENK",
        "first_name": "ANDREAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT17427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE IND PROV # EASTLAKE",
            "identifier": "WPT17427B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE IND PROV # CORONADO",
            "identifier": "WPT17427C",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.