Organization Active NPI

Physical Therapy-Sports Institute, Inc.

  • Physical Therapist
  • Hemet, CA
National Provider Identifier
1811050156
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY-SPORTS INSTITUTE, INC.
Practice address
1515 W Florida Ave
Suite E
Hemet, CA 92543-3817
Phone
(951) 658-3121
Fax
(951) 652-6994
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Michael Foutz
Title
President
Phone
(951) 791-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1515 W Florida Ave
Suite E
Hemet, CA 92543-3817

Mailing address

1545 W Florida Ave
Hemet, CA 92543-3814
Phone (951) 791-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050512000559 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2163463878 Receives reassigned benefits from 5 practitioners
Practice locations: Hemet, CA

National Provider Directory

National Provider Directory

Locations

2390 E Florida Ave
Ste 103
Hemet, CA 92544
Phone (951) 766-0374

Practitioners & affiliated clinicians

Practitioners 5

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1811050156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 W FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433814",
            "telephone_number": "951-791-1111",
            "fax_number": "951-925-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W FLORIDA AVE",
            "address_2": "SUITE E",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433817",
            "telephone_number": "951-658-3121",
            "fax_number": "951-652-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY-SPORTS INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "FOUTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-791-1111"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.