Individual provider Active NPI

Deborah Struiksma, PT

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1760622773
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT22400 Issued in CA
Practice address
12465 Lewis St
Suite 101
Garden Grove, CA 92840-4681
Phone
(714) 703-8477
Fax
(714) 703-8157
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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 PT22400 CA Primary

Addresses

Primary practice location

12465 Lewis St
Suite 101
Garden Grove, CA 92840-4681

Mailing address

12465 Lewis St
Suite 101
Garden Grove, CA 92840-4681
Phone (714) 703-8477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000588 CA Practitioner - Physical Therapist in Private Practice 9436204112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Balance Solution Institute of Physiotherapy IncGroup PAC ID 2062427305, 29 clinicians

Practice addresses (Care Compare)

18 Endeavor
Suite 208
Irvine, CA 92618-3181
Phone (949) 340-6927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT22400CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In-Home Physical Therapy PC CurrentSince Mar 19, 2015 Accepting new patients
Complete Balance Solution Institute of Physiotherapy Inc Physical Therapist CurrentSince Feb 24, 2015 Accepting new patients
Ascend Physical Therapy, Inc Physical Therapist PastSince May 1, 2015 Accepting new patients
PNP Associates Past Accepting new patients

Locations

533 2nd St
Ste 341
Encinitas, CA 92024
Phone (760) 271-3850

18 Endeavor
Ste 208
Irvine, CA 92618
Phone (949) 276-4008

18 Endeavor
Ste 105
Irvine, CA 92618
Phone (949) 340-6927

23141 Moulton Pkwy
Ste 111
Laguna Hills, CA 92653
Phone (949) 340-6927

13001 Seal Beach Blvd
Ste 100
Seal Beach, CA 90740
Phone (310) 799-6666

Organizations & group practices 4

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": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1760622773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404681",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST",
            "address_2": "SUITE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404681",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUIKSMA",
        "first_name": "DEBORAH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT22400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.