NPIMap

Organization Active NPI

State College Physical Therapy

  • Physical Therapist
  • Anaheim, CA
National Provider Identifier
1699780353
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9743 Issued in CA
Legal business name
STATE COLLEGE PHYSICAL THERAPY
Practice address
215 N State College Blvd
Suite G
Anaheim, CA 92806-2913
Phone
(714) 999-6596
Fax
(714) 999-5009
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Parivash Oreizy, P.T.NPI 1043231277
Title
President
Phone
(714) 999-6598

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT9743 CA Primary

Addresses

Primary practice location

215 N State College Blvd
Suite G
Anaheim, CA 92806-2913

Mailing address

215 N State College Blvd
Suite G
Anaheim, CA 92806-2913
Phone (714) 999-6596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040812000641 CA Part B Supplier - Clinic/Group Practice 2769454388 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anaheim, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Anaheim Hills Physical Therapy Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

215 N State College Blvd
Ste G
Anaheim, CA 92806
Phone (714) 685-0700

Practitioners & affiliated clinicians

Practitioners 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1699780353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD",
            "address_2": "SUITE G",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062913",
            "telephone_number": "714-999-6596",
            "fax_number": "714-999-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N STATE COLLEGE BLVD",
            "address_2": "SUITE G",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928062913",
            "telephone_number": "714-999-6596",
            "fax_number": "714-999-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE COLLEGE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "OREIZY",
        "authorized_official_first_name": "PARIVASH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-999-6598",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.