Individual provider Active NPI

Gina Yvette Macdonald, DR. PHYSICAL THERAPY

  • Specialist
  • Seal Beach, CA
National Provider Identifier
1700990694
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT24673 Issued in CA
Practice address
550 Pacific Coast Hwy
Suite 203
Seal Beach, CA 90740-5999
Phone
(562) 493-5095
Fax
(562) 493-5148
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT24673 CA Primary

Addresses

Primary practice location

550 Pacific Coast Hwy
Suite 203
Seal Beach, CA 90740-5999

Mailing address

6301 Farinella Dr
Huntington Beach, CA 92647-4221
Phone (714) 840-5671

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060830000302 CA Practitioner - Physical Therapist in Private Practice 0941204127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Sunset Physical Therapy CorporationGroup PAC ID 7517949860, 3 clinicians

Practice addresses (Care Compare)

550 Pacific Coast Hwy
Suite 203
Seal Beach, CA 90740-6652
Phone (562) 493-5095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24673CAMDClinical Neuropsychologist
PT24673CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Physical Therapy Corporation CurrentSince Jun 20, 2006 Accepting new patients

Locations

550 Pacific Coast Hwy
Ste 203
Seal Beach, CA 90740
Phone (562) 493-5095

Organizations & group practices 1

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700990694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 FARINELLA DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474221",
            "telephone_number": "714-840-5671",
            "fax_number": "562-493-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PACIFIC COAST HWY",
            "address_2": "SUITE 203",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907405999",
            "telephone_number": "562-493-5095",
            "fax_number": "562-493-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "GINA",
        "middle_name": "YVETTE",
        "name_prefix": "Dr.",
        "credential": "DR. PHYSICAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT24673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.