Individual provider Active NPI

Lorna S Beukema, PT

  • Physical Therapist
  • San Mateo, CA
National Provider Identifier
1710483631
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11527 Issued in CA
Practice address
1660 S Amphlett Blvd Ste 116
San Mateo, CA 94402-2507
Phone
(650) 453-5100
Fax
(650) 453-5100
NPI assigned
Mar 30, 2018
Last updated
Mar 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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 11527 CA Primary

Addresses

Primary practice location

1660 S Amphlett Blvd Ste 116
San Mateo, CA 94402-2507

Mailing address

329 Elm St
San Mateo, CA 94401-2511
Phone (650) 759-7448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11527CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Agility Health CurrentSince Dec 22, 2020 Accepting new patients
Nursing & Rehab at Home CurrentSince Dec 22, 2020 Accepting new patients

Locations

1660 S Amphlett Blvd
Ste 116
San Mateo, CA 94402
Phone (650) 453-5100

1710 S Amphlett Blvd
Ste 110
San Mateo, CA 94402
Phone (209) 573-3006

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": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1710483631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 ELM ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012511",
            "telephone_number": "650-759-7448",
            "fax_number": "650-249-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S AMPHLETT BLVD STE 116",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022507",
            "telephone_number": "650-453-5100",
            "fax_number": "650-453-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEUKEMA",
        "first_name": "LORNA",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "11527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.