Individual provider Active NPI

Ryan Jacobi, PT, DPT

  • Physical Therapist
  • Rancho Santa Margarita, CA
National Provider Identifier
1790439677
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301655 Issued in CA
Practice address
22342 El Paseo Ste G
Rancho Santa Margarita, CA 92688-5804
Phone
(949) 755-0796
NPI assigned
Feb 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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 301655 CA Primary

Addresses

Primary practice location

22342 El Paseo Ste G
Rancho Santa Margarita, CA 92688-5804

Mailing address

30 Via Jolitas
Rancho Santa Margarita, CA 92688-2974
Phone (949) 813-5678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
301655CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1790439677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 VIA JOLITAS",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882974",
            "telephone_number": "949-813-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22342 EL PASEO STE G",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926885804",
            "telephone_number": "949-755-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBI",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.