Individual provider Active NPI

Shannon Ye

  • Physical Therapist
  • Glendale, CA
National Provider Identifier
1740959857
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
300775 Issued in CA
Practice address
3810 La Crescenta Ave
Glendale, CA 91214-3914
Phone
(818) 369-7700
NPI assigned
Sep 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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 300775 CA Primary

Addresses

Primary practice location

3810 La Crescenta Ave
Glendale, CA 91214-3914

Mailing address

3810 La Crescenta Ave
Glendale, CA 91214-3914

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.tylerphysicaltherapy.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211221002167 CA Practitioner - Physical Therapist in Private Practice 1153712468 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
300775CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Physical Therapy Specialists, Inc Physical Therapist CurrentSince Apr 1, 2023 Accepting new patients
Tyler Physical Therapy Inc Physical Therapist CurrentSince Nov 24, 2021 Accepting new patients
Foothill Family Service - Hudson PastSince Apr 1, 2023 Accepting new patients

Locations

3810 La Crescenta Ave
La Crescenta, CA 91214
Phone (818) 369-7620

3800 Foothill Blvd
Ste A
La Crescenta, CA 91214
Phone (818) 369-7700

111 S Hudson Ave
Pasadena, CA 91101
Phone (626) 683-8536

Organizations & group practices 3

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": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1740959857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 LA CRESCENTA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912143914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 LA CRESCENTA AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912143914",
            "telephone_number": "818-369-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YE",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.tylerphysicaltherapy.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3810 La Crescenta Ave",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912143914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.