Individual provider Active NPI

Miranda Judge

  • Physical Therapist
  • Apple Valley, CA
National Provider Identifier
1710633565
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
16008 Kamana Rd Ste 200
Apple Valley, CA 92307-1376
Phone
(760) 810-7767
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 Primary

Addresses

Primary practice location

16008 Kamana Rd Ste 200
Apple Valley, CA 92307-1376

Mailing address

24630 Washington Ave Ste 201
Murrieta, CA 92562-6177
Phone (195) 120-0362

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419001387 CA Practitioner - Physical Therapist in Private Practice 3678960853 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians
Udea Physical Therapy IncGroup PAC ID 3476094913, 3 clinicians

Practice addresses (Care Compare)

16008 Kamana Rd
Suite 200
Apple Valley, CA 92307-1376
Phone (760) 810-7767

4035 E Thousand Oaks Blvd
Suite 255
Westlake Village, CA 91362-3633
Phone (424) 781-7872

615 W Ave L
Lancaster, CA 93534-7211
Phone (661) 729-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Udea Physical Therapy Inc Physical Therapist CurrentSince Jan 27, 2026 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 30, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
All Star Physical Therapy Physical Therapist CurrentSince Mar 25, 2022 Accepting new patients
Elite Physical Therapy and Wellness, Inc. Physical Therapist CurrentSince Mar 6, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 30, 2024 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

43112 15th St W
Lancaster, CA 93534
Phone (661) 726-2222

615 W Avenue L
Lancaster, CA 93534
Phone (661) 723-2815

24630 Washington Ave
Ste 201
Murrieta, CA 92562
Phone (951) 200-3620

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

4035 E Thousand Oaks Blvd
Ste 255
Westlake Village, CA 91362
Phone (323) 481-9085

Organizations & group practices 6

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": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1710633565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24630 WASHINGTON AVE STE 201",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925626177",
            "telephone_number": "195-120-0362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16008 KAMANA RD STE 200",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071376",
            "telephone_number": "760-810-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2024-12-30",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 15th St W",
            "city": "Lancaster",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.