Individual provider Active NPI

Sofia Costa, PT, DPT

  • Orthopedic Physical Therapist
  • Santa Monica, CA
National Provider Identifier
1720323702
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
39664 Issued in CA
Practice address
900 Wilshire Blvd
Suit #318
Santa Monica, CA 90401-1872
Phone
(347) 451-3626
Fax
(424) 272-9772
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 39664 CA Primary

Addresses

Primary practice location

900 Wilshire Blvd
Suit #318
Santa Monica, CA 90401-1872

Mailing address

932 14TH St
Unit #3
Santa Monica, CA 90403-3186
Phone (956) 357-6774

Other identifiers 1

IdentifierTypeStateIssuer
39664OtherCASTATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
39664CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Terrapin Physical Therapy Inc PC Orthopedic PastSince Dec 5, 2005 Accepting new patients
Strongharte Fitness & Physical Orthopedic Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1720323702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 14TH ST",
            "address_2": "UNIT #3",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904033186",
            "telephone_number": "956-357-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILSHIRE BLVD",
            "address_2": "SUIT #318",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011872",
            "telephone_number": "347-451-3626",
            "fax_number": "424-272-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "SOFIA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "39664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "39664",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; 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.