Hadji Alejandro Dedace, P.T.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT32175 Issued in CA

Practice address

1624 W Olive Ave Ste E
Burbank, CA 91506-2459

Phone

(818) 846-1441

Fax

(818) 846-1419

NPI assigned

Oct 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imperial Burbank Physical Therapy IncGroup PAC ID 0547205734, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Imperial Burbank Physical Therapy Inc

  • Physical Therapist
  • Burbank, CA
  • NPI 1336250992
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689762585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 W. OLIVE SUITE E",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91506",
            "telephone_number": "818-846-1441",
            "fax_number": "818-846-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 W OLIVE AVE STE E",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062459",
            "telephone_number": "818-846-1441",
            "fax_number": "818-846-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDACE",
        "first_name": "HADJI",
        "middle_name": "ALEJANDRO",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "PT32175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "PT 32175",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dinusha De Silva- Carrasco, DSW, LCSW
• Makaylah De St Jeor, LCSW
• Daniel Kwan Dea, M.D.
• Deandrea Knight LCSW Inc
• Elizabeth Dearborn
• Valerie Defino
• Dan Richard Dehovitz, M.D.
• Jessica Deiso, MSPT
• Elizabeth A. Del Re, R.N.
• Aime Del Valle, NURSE PRACTITIONER

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.