Individual provider Active NPI

Jake Hodgens, PT, DPT

  • Physical Therapist
  • Encinitas, CA
National Provider Identifier
1740869668
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
300007 Issued in CA
Practice address
613 Westlake St Ste 130
Encinitas, CA 92024-3866
Phone
(858) 755-5200
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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 300007 CA Primary

Addresses

Primary practice location

613 Westlake St Ste 130
Encinitas, CA 92024-3866

Mailing address

380 Stevens Ave Ste 314
Solana Beach, CA 92075-2069

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.risephysicaltherapy.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211105000650 CA Practitioner - Physical Therapist in Private Practice 2961891395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Rise Physical Therapy IncGroup PAC ID 2062636079, 55 clinicians

Practice addresses (Care Compare)

12245 World Trade Dr
Suite K
San Diego, CA 92128-3770
Phone 858755520024

1420 Grand Ave
Suite J
San Marcos, CA 92078-2448
Phone (858) 755-5200

380 Stevens Ave
Suite 314
Solana Beach, CA 92075-2069
Phone (858) 755-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1740869668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 STEVENS AVE STE 314",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 WESTLAKE ST STE 130",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243866",
            "telephone_number": "858-755-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGENS",
        "first_name": "JAKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.risephysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "613 Westlake St Ste 130",
            "city": "Encinitas",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920243866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.