Active NPI
Dynamic Physical Therapy and Sports Performance, Inc
- Physical Therapy Clinic/Center
- Palm Desert, CA
National Provider Identifier
1770958670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- DYNAMIC PHYSICAL THERAPY AND SPORTS PERFORMANCE, INC
- Practice address
- 44651 Village CT Ste 120
Palm Desert, CA 92260-3823 - Phone
- (760) 501-6655
- NPI assigned
- Dec 3, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Karen E. Elbert, PT, DPT, OCS
- Title
- President
- Phone
- (515) 320-6046
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
44651 Village CT Ste 120
Palm Desert, CA 92260-3823
Mailing address
44651 Village CT Ste 120
Palm Desert, CA 92260-3823
Phone (760) 501-6655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160629000230 | CA | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5092004051 |
Receives reassigned benefits from 4 practitioners Practice locations: Palm Desert, CA |
National Provider Directory
National Provider DirectoryLocations
44651 Village Ct
Ste 120
Palm Desert, CA 92260
Phone (760) 501-6655
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopedic Physical Therapist
- Palm Desert, CA
- NPI 1871730556
CA, Physical Therapist
-
- Physical Therapist
- Palm Desert, CA
- NPI 1801036819
CA, Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1454630400000",
"number": "1770958670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44651 VILLAGE CT STE 120",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603823",
"telephone_number": "760-501-6655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44651 VILLAGE CT STE 120",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603823",
"telephone_number": "760-501-6655"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC PHYSICAL THERAPY AND SPORTS PERFORMANCE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-12-03",
"last_updated": "2016-02-05",
"status": "A",
"authorized_official_last_name": "ELBERT",
"authorized_official_first_name": "KAREN",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "515-320-6046",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PT, DPT, OCS"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.