Organization Active NPI

Body and Mind Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1699306407
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BODY AND MIND PHYSICAL THERAPY INC.
Practice address
1125 E 17TH St Ste W237
Santa Ana, CA 92701-2205
Phone
(714) 760-4577
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Saeideh BadiefardNPI 1821418492
Title
Owner
Phone
(908) 295-6187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1125 E 17TH St Ste W237
Santa Ana, CA 92701-2205

Mailing address

1125 E 17TH St Ste W237
Santa Ana, CA 92701-2205
Phone (908) 295-6187

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200807002269 CA Part B Supplier - Clinic/Group Practice 8123443124 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Ana, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1699306407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST STE W237",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012205",
            "telephone_number": "908-295-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E 17TH ST STE W237",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012205",
            "telephone_number": "714-760-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY AND MIND PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "BADIEFARD",
        "authorized_official_first_name": "SAEIDEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-295-6187"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 May 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.