Individual provider Active NPI

Peter John Konopasky, RPT

  • Physical Therapist
  • Laguna Hills, CA
National Provider Identifier
1720169980
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16805 Issued in CA
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

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
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 IDStateProvider typePAC IDDetails
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 CorporGroup PAC ID 1658268180, 5 clinicians

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

LicenseStateTypeSpecialty
PT16805CAMDPhysical 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.

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.

Verify at the official NPI Registry.