Individual provider Active NPI

Amanda Jessica Rosette, PT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1700050465
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33913 Issued in CA
Practice address
6707 Springpark Ave
#6
Los Angeles, CA 90056-2364
Phone
(310) 872-0977
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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 33913 CA Primary

Addresses

Primary practice location

6707 Springpark Ave
#6
Los Angeles, CA 90056-2364

Mailing address

6707 Springpark Ave
#6
Los Angeles, CA 90056-2364
Phone (310) 872-0977

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (877) 390-6659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000720 CA Practitioner - Physical Therapist in Private Practice 2163592312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6707 Springpark Ave
Apt 6
Los Angeles, CA 90056-2305
Phone (310) 872-0977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33913CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosette Physical Therapy, P.C Physical Therapist CurrentSince Apr 18, 2019 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Friendly Health, Inc. PastSince Nov 26, 2023 Accepting new patients
Manhattan Beach Pacific Physical Therapy Inc Physical Therapist PastSince Mar 1, 2017 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

Organizations & group practices 4

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1700050465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6707 SPRINGPARK AVE",
            "address_2": "#6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900562364",
            "telephone_number": "310-872-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6707 SPRINGPARK AVE",
            "address_2": "#6",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900562364",
            "telephone_number": "310-872-0977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "877-390-6659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSETTE",
        "first_name": "AMANDA",
        "middle_name": "JESSICA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.