Scott Agbincola, PT
Individual provider Active NPI Physical Therapist · El Segundo, CA
NPI 1700818192 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1700818192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT28894 (CA)
- Practice address
- 2250 Park PL
El Segundo, CA 90245-4908 - Phone
- (310) 643-9016
- Fax
- (310) 536-0177
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- University of California, San Francisco School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- California Luna Care Physical Therapy PC
Practice addresses (Care Compare)
16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080512000290 | CA | Practitioner - Physical Therapist in Private Practice | 9032298369 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT28894 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Luna Care Physical Therapy PC | Physical Therapist | Current |
Accepting new patients |
Locations
16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT28894 | CA | Yes |
Addresses
Primary practice location
2250 Park PL
El Segundo, CA 90245-4908
Mailing address
7730 Paseo del Rey Apt 1
Playa del Rey, CA 90293-8345
Phone (310) 643-9016
Other providers in El Segundo, CA
- Dikshya Adhikari
- Anjelika Marin Adraneda
- Elizabeth A Adriany
- Amina Afzili
- Oghenefegor Agatovure
- Sydney Age
- Talia Agee
- Aleen Aghabi
- America Aguayo
- Hailey Aguayo
All providers in El Segundo, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.