Individual provider Active NPI

Alexandra Clare Ceridwen Rimmer, DPT

  • Physical Therapist
  • El Segundo, CA
National Provider Identifier
1710401815
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT293436 Issued in CA
Practice address
555 N Nash St
El Segundo, CA 90245-2818
Phone
(310) 666-9003
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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 PT293436 CA Primary

Addresses

Primary practice location

555 N Nash St
El Segundo, CA 90245-2818

Mailing address

1084 N El Camino Real # B-351
Encinitas, CA 92024-1334
Phone (760) 918-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831002369 CA Practitioner - Physical Therapist in Private Practice 3476826116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Function for Life Physical Therapy IncGroup PAC ID 3678758489, 36 clinicians

Practice addresses (Care Compare)

555 N Bash St
El Segundo, CA 90245-2818
Phone (310) 666-9003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT293436CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2017 Accepting new patients
Function for Life Physical Therapy, Inc. Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

2719 Loker Ave W
Ste A
Carlsbad, CA 92010
Phone (760) 918-9200

555 N Nash St
El Segundo, CA 90245
Phone (310) 386-6788

1084 N El Camino Real
#B351
Encinitas, CA 92024

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1640 Marengo St
Ste 102
Los Angeles, CA 90033
Phone (323) 224-7070

1640 Marengo St
Los Angeles, CA 90033
Phone (323) 223-4091

Organizations & group practices 3

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1710401815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 N EL CAMINO REAL # B-351",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241334",
            "telephone_number": "760-918-9200",
            "fax_number": "760-918-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NASH ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452818",
            "telephone_number": "310-666-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIMMER",
        "first_name": "ALEXANDRA",
        "middle_name": "CLARE CERIDWEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT293436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.