Active NPI
Jake Hodgens, PT, DPT
- Physical Therapist
- Encinitas, CA
National Provider Identifier
1740869668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 300007
- 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
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 | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.risephysicaltherapy.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
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.
-
- Physical Therapy Clinic/Center
- Solana Beach, CA
- NPI 1083038764
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.