Individual provider Active NPI

Shalmali Santosh Thosar, PT

  • Physical Therapist
  • San Bernardino, CA
National Provider Identifier
1770194680
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298653 Issued in CA
Practice address
1181 E Highland Ave Ste B
San Bernardino, CA 92404-4605
Phone
(909) 883-5069
Fax
(909) 883-5473
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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 298653 CA Primary

Addresses

Primary practice location

1181 E Highland Ave Ste B
San Bernardino, CA 92404-4605

Mailing address

PO Box 10016
Redlands, CA 92375-3216
Phone (909) 883-5069

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210510000382 CA Practitioner - Physical Therapist in Private Practice 0244649994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Loma Linda University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete P T Pool and Land Physical Therapy IncGroup PAC ID 5890853766, 15 clinicians

Practice addresses (Care Compare)

3283 Motor Ave
Los Angeles, CA 90034-3709
Phone (310) 845-9690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298653CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete P T Pool and Land Physical Therapy Inc CurrentSince Feb 25, 2026 Accepting new patients

Locations

3283 Motor Ave
Los Angeles, CA 90034
Phone (310) 559-6900

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1770194680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10016",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923753216",
            "telephone_number": "909-883-5069",
            "fax_number": "909-883-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 E HIGHLAND AVE STE B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044605",
            "telephone_number": "909-883-5069",
            "fax_number": "909-883-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOSAR",
        "first_name": "SHALMALI",
        "middle_name": "SANTOSH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.