Individual provider Active NPI

Derick Tom

  • Physical Therapist
  • Long Beach, CA
National Provider Identifier
1801221890
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2021 N. Beverly Plaza Apt#142
Long Beach, CA 90815
Phone
(909) 993-7663
NPI assigned
Sep 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2021 N. Beverly Plaza Apt#142
Long Beach, CA 90815

Mailing address

2021 N. Beverly Plaza Apt#142
Long Beach, CA 90815
Phone (909) 993-7663

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

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

Practice roles

OrganizationSpecialtyStatusNew patients
Feld Care Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1801221890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 N. BEVERLY PLAZA APT#142",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "909-993-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N. BEVERLY PLAZA APT#142",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90815",
            "telephone_number": "909-993-7663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOM",
        "first_name": "DERICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-09",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.