Individual provider Active NPI

Haesun Han, PT

  • Orthopedic Physical Therapist
  • Rancho Cordova, CA
National Provider Identifier
1811333669
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT 39884 Issued in CA
Practice address
1995 Zinfandel Dr
Suite 205
Rancho Cordova, CA 95670-2862
Phone
(916) 635-9199
NPI assigned
May 21, 2013
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT 39884 CA Primary

Addresses

Primary practice location

1995 Zinfandel Dr
Suite 205
Rancho Cordova, CA 95670-2862

Mailing address

1995 Zinfandel Dr
Suite 205
Rancho Cordova, CA 95670-2862
Phone (916) 635-9199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230320000456 CA Practitioner - Physical Therapist in Private Practice 3779957527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1301 E Bidwell St
Suite 101
Folsom, CA 95630-3565
Phone (916) 983-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 39884CAMDOrthopedic Physical Therapist
39884CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Burger Physical Therapy Services Inc CurrentSince Jan 18, 2023 Accepting new patients
Burger Physical Therapy and Rehabilitation Agency Inc PastSince Jan 18, 2023 Accepting new patients

Locations

1301 E Bidwell St
Ste 101
Folsom, CA 95630
Phone (916) 983-5900

7200 S Land Park Dr
Ste 300
Sacramento, CA 95831
Phone (916) 391-5010

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1811333669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ZINFANDEL DR",
            "address_2": "SUITE 205",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702862",
            "telephone_number": "916-635-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ZINFANDEL DR",
            "address_2": "SUITE 205",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702862",
            "telephone_number": "916-635-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "HAESUN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT 39884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.