Individual provider Active NPI

Tiffany Ann So, PT

  • Physical Therapist
  • Alhambra, CA
National Provider Identifier
1700505328
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
302711 Issued in CA
Practice address
41 N Garfield Ave Ste 102
Alhambra, CA 91801-7501
Phone
(626) 782-7611
Fax
(626) 782-7612
NPI assigned
Aug 25, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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 302711 CA Primary

Addresses

Primary practice location

41 N Garfield Ave Ste 102
Alhambra, CA 91801-7501

Mailing address

41 N Garfield Ave Ste 102
Alhambra, CA 91801-7501
Phone (626) 782-7611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927000306 CA Practitioner - Physical Therapist in Private Practice 8527444702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
B and C Physical Therapy IncGroup PAC ID 8224391230, 5 clinicians

Practice addresses (Care Compare)

41 N Garfield Ave
Suite 102
Alhambra, CA 91801-7501
Phone (626) 782-7611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302711CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
B & C Physical Therapy, Inc. Physical Therapist CurrentSince Aug 12, 2022 Accepting new patients
Total Body Center Inc Physical Therapist PastSince Aug 12, 2022 Accepting new patients

Locations

41 N Garfield Ave
Ste 102
Alhambra, CA 91801
Phone (626) 282-1988

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1700505328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 N GARFIELD AVE STE 102",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017501",
            "telephone_number": "626-782-7611",
            "fax_number": "626-782-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 N GARFIELD AVE STE 102",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918017501",
            "telephone_number": "626-782-7611",
            "fax_number": "626-782-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.