Individual provider Active NPI

Jaclyn Michaela Perakis, DPT

  • Physical Therapist
  • El Centro, CA
National Provider Identifier
1770958621
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
43480 Issued in CA
Practice address
426 N Imperial Ave
El Centro, CA 92243-2329
Phone
(760) 592-8148
Fax
(760) 841-5556
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 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 43480 CA Primary

Addresses

Primary practice location

426 N Imperial Ave
El Centro, CA 92243-2329

Mailing address

3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (858) 264-1434

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205000235 CA Practitioner - Physical Therapist in Private Practice 0042514465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

1020 Tierra del Rey
Suite a 1
Chula Vista, CA 91910-7886
Phone (619) 585-7104

1602 A N Imperial Ave
El Centro, CA 92243-1319
Phone (760) 299-7741

2300 N Imperial Ave
Suite H
Calexico, CA 92231-3209
Phone (760) 890-7050

2600 Dallas Pkwy
Suite 290
Frisco, TX 75034-7493

409 W Main St
Brawley, CA 92227-2244
Phone (760) 925-3031

426 N Imperial Ave
El Centro, CA 92243-2329
Phone (760) 592-8148

Merit-based Incentive Payment System (MIPS)

Final score
62.68 of 100Reported as individual
Quality
36.29
Improvement activities
40
Cost
68.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jan 1, 2017 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jan 1, 2017 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Dec 2, 2015 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

409 W Main St
Brawley, CA 92227
Phone (760) 925-3031

2300 N Imperial Ave
Ste H
Calexico, CA 92231
Phone (607) 890-7050

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

426 N Imperial Ave
El Centro, CA 92243
Phone (760) 592-8148

1611 W Main St
El Centro, CA 92243
Phone (760) 337-1144

317 N El Camino Real
Ste 210
Encinitas, CA 92024
Phone (760) 337-1144

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

3707 Convoy St
Ste 100
San Diego, CA 92111
Phone (858) 573-9368

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

5850 Canoga Ave
Ste 120
Woodland Hills, CA 91367
Phone (747) 255-4089

Organizations & group practices 6

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1770958621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-264-1434",
            "fax_number": "858-751-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N IMPERIAL AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922432329",
            "telephone_number": "760-592-8148",
            "fax_number": "760-841-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAKIS",
        "first_name": "JACLYN",
        "middle_name": "MICHAELA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "43480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.