NPIMap

Organization Active NPI

St. Charles Spine Institute

  • Physical Medicine & Rehabilitation Physician
  • Thousand Oaks, CA
National Provider Identifier
1780377283
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ST. CHARLES SPINE INSTITUTE
Practice address
1001 Newbury Rd
Thousand Oaks, CA 91320-6434
Phone
(805) 379-2322
Fax
(805) 379-6786
NPI assigned
May 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Monica Fandino
Title
Billing Manager
Phone
(805) 379-2322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

1001 Newbury Rd
Thousand Oaks, CA 91320-6434

Mailing address

1001 Newbury Rd
Thousand Oaks, CA 91320-6434
Phone (805) 379-2322

Other practice location 1

558 Saint Charles Dr Ste 200
Thousand Oaks, CA 91360-3968
Phone (805) 379-2322 ext. 109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170103001487 CA Part B Supplier - Clinic/Group Practice 5496036550 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Thousand Oaks, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1780377283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NEWBURY RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206434",
            "telephone_number": "805-379-2322",
            "fax_number": "805-379-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NEWBURY RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913206434",
            "telephone_number": "805-379-2322",
            "fax_number": "805-379-6786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "558 Saint Charles Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Thousand Oaks",
            "state": "CA",
            "postal_code": "913603968",
            "country_code": "US",
            "telephone_number": "805-379-2322 x109",
            "fax_number": "805-379-2373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. CHARLES SPINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "FANDINO",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "805-379-2322"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.