Active NPI
Peter John Konopasky, RPT
- Physical Therapist
- Laguna Hills, CA
National Provider Identifier
1720169980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT16805
- Practice address
- 24431 Calle de la Louisa
200
Laguna Hills, CA 92653-7641 - Phone
- (949) 837-2113
- Fax
- (949) 837-2040
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT16805 | CA | Primary |
Addresses
Primary practice location
24431 Calle de la Louisa
200
Laguna Hills, CA 92653-7641
Mailing address
24431 Calle de la Louisa
200
Laguna Hills, CA 92653-7641
Phone (949) 837-2113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120202000142 | CA | Practitioner - Physical Therapist in Private Practice | 1456248988 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Physical Therapy of Laguna-Viejo a Professional Corpor
Practice addresses (Care Compare)
26034 Acero
Mission Viejo, CA 92691-2768
Phone (949) 837-9074
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT16805 | CA | MD | Physical Therapist |
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.
-
- Physical Therapist
- Mission Viejo, CA
- NPI 1659452829
CA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720169980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24431 CALLE DE LA LOUISA",
"address_2": "200",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926537641",
"telephone_number": "949-837-2113",
"fax_number": "949-837-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24431 CALLE DE LA LOUISA",
"address_2": "200",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926537641",
"telephone_number": "949-837-2113",
"fax_number": "949-837-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONOPASKY",
"first_name": "PETER",
"middle_name": "JOHN",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT16805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laguna Hills, 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.