Individual provider Active NPI

Carlos Brain

  • Physical Therapist
  • Thousand Oaks, CA
National Provider Identifier
1760543946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
250 Fairview Rd
Thousand Oaks, CA 91361-2456
Phone
(818) 838-0667
Fax
(818) 838-0406
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 CA Primary

Addresses

Primary practice location

250 Fairview Rd
Thousand Oaks, CA 91361-2456

Mailing address

10600 Sepulveda Blvd
Ste 111
Mission Hills, CA 91345-1900
Phone (818) 838-0667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000486 CA Practitioner - Physical Therapist in Private Practice 7214970169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Newbury Rd
Suite 120
Thousand Oaks, CA 91320-6437
Phone (805) 375-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthotherapetucis CurrentSince Jan 22, 2024 Accepting new patients

Locations

1000 Newbury Rd
Ste 120
Thousand Oaks, CA 91320
Phone (805) 375-0001

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760543946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 SEPULVEDA BLVD",
            "address_2": "STE 111",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913451900",
            "telephone_number": "818-838-0667",
            "fax_number": "818-838-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 FAIRVIEW RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913612456",
            "telephone_number": "818-838-0667",
            "fax_number": "818-838-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAIN",
        "first_name": "CARLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.