Individual provider Active NPI

Lena Elisseev, DPT

  • Physical Therapist
  • Woodland Hills, CA
National Provider Identifier
1720412927
Registry record updated Aug 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34082 Issued in CA
Practice address
23020 Lita PL
Woodland Hills, CA 91364-4849
Phone
(747) 888-4141
NPI assigned
Aug 25, 2013
Last updated
Aug 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34082 CA Primary
Geriatric Physical Therapist 2251G0304X 34082 CA

Addresses

Primary practice location

23020 Lita PL
Woodland Hills, CA 91364-4849

Mailing address

23020 Lita PL
Woodland Hills, CA 91364-4849

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220719001283 MA Practitioner - Physical Therapist in Private Practice 3678954815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34082CAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab Ma LLC Physical Therapist CurrentSince Jun 1, 2022 Accepting new patients

Locations

303 Wyman St
Ste 300
Waltham, MA 02451
Phone (781) 330-0577

7 Carnegie Plz
Cherry Hill, NJ 08003

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, 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": "1377388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377388800000",
    "number": "1720412927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23020 LITA PL",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913644849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23020 LITA PL",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913644849",
            "telephone_number": "747-888-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELISSEEV",
        "first_name": "LENA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-25",
        "last_updated": "2013-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34082",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "34082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.