Individual provider Active NPI

Laraven S Waterman, PT, DPT

  • Physical Therapist
  • Monterey, CA
National Provider Identifier
1770231045
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
310451 Issued in CA
Practice address
5 Harris CT BLDG T
Monterey, CA 93940-5750
Phone
(831) 372-3579
Fax
(831) 372-3779
NPI assigned
Mar 15, 2022
Last updated
Sep 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5091 AR
Physical Therapist 225100000X PT41456 FL
Physical Therapist 225100000X 310451 CA Primary

Addresses

Primary practice location

5 Harris CT BLDG T
Monterey, CA 93940-5750

Mailing address

5 Harris CT BLDG T
102
Monterey, CA 93940-5750
Phone (831) 372-3579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118000097 FL Practitioner - Physical Therapist in Private Practice 7416335997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

11375 Big Bend Rd
Riverview, FL 33579-7183
Phone (813) 805-8167

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 823-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5091ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies-Riverview, LLC Physical Therapist CurrentSince Nov 11, 2024 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Mar 1, 2026 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Mar 1, 2026 Accepting new patients
Optimal Performance and Physical Therapies Northdale LLC Physical Therapist CurrentSince Nov 17, 2024 Accepting new patients
Terrapin Physical Therapy Physical Therapist Past Accepting new patients
Terrapin Physical Therapy Inc PC Physical Therapist Past Accepting new patients
Ohi West Medical Group, LLC Past Accepting new patients

Locations

14004 Roosevelt Blvd
Ste 613
Clearwater, FL 33762

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

11375 Big Bend Rd
Riverview, FL 33579
Phone (813) 805-8167

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1770231045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HARRIS CT BLDG T",
            "address_2": "102",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405750",
            "telephone_number": "831-372-3579",
            "fax_number": "831-372-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HARRIS CT BLDG T",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405750",
            "telephone_number": "831-372-3579",
            "fax_number": "831-372-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "LARAVEN",
        "middle_name": "S",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5091",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41456",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "310451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.