Samuel Michael Herringshaw, DPT, PT
Individual provider Active NPI Physical Therapist · Foothill Ranch, CA
NPI 1801665369 · NPPES record last updated Dec 26, 2023
Key facts
- NPI
- 1801665369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 305344 (CA)
- Practice address
- 26672 Portola Pkwy Ste 116
Foothill Ranch, CA 92610-1773 - Phone
- (800) 788-5753
- NPI assigned
- Dec 26, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Rise Physical Therapy Inc
Practice addresses (Care Compare)
15375 Barranca Pkwy
Suite A103
Irvine, CA 92618-2203
Phone (949) 590-9350
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240205001362 | CA | Practitioner - Physical Therapist in Private Practice | 7719320993 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rise Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
Locations
15375 Barranca Pkwy
Ste A103
Irvine, CA 92618
Phone (949) 590-9350
380 Stevens Ave
Ste 314
Solana Beach, CA 92075
Phone 858755520024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 305344 | CA | Yes |
Addresses
Primary practice location
26672 Portola Pkwy Ste 116
Foothill Ranch, CA 92610-1773
Mailing address
9340 Culinary PL
Rancho Cucamonga, CA 91730-5736
Phone (270) 734-5596
Other providers in Foothill Ranch, CA
- Soha Haghani
- Michale Wayne Hamlin
- Suzan Hashemi
- Amina Hassan-Elsayed
- Roy Masato Hayashi
- Gregg E Hill
- Jacob Holman
- Hootan Daneshmand M D Incorporated
- Hospice Care of the West, LLC
- Shelton Hsu
All providers in Foothill Ranch, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.