Individual provider Active NPI

Steven A Roseboro

  • Orthopedic Physical Therapist
  • Torrance, CA
National Provider Identifier
1821184946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT9920 Issued in CA
Practice address
1407 Crenshaw Blvd Ste 103
Torrance, CA 90501-0424
Phone
(310) 320-6659
Fax
(310) 320-6713
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT9920 CA Primary

Addresses

Primary practice location

1407 Crenshaw Blvd Ste 103
Torrance, CA 90501-0424

Mailing address

1407 Crenshaw Blvd Ste 103
Torrance, CA 90501-0424
Phone (310) 320-6659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100807000010 CA Practitioner - Physical Therapist in Private Practice 0042343345 Reassigns benefits to 2 organizations
Practice locations: Hawthorne, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Connecticut School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ilya Kaminsky DC a Professional CorporationGroup PAC ID 8325190168, 7 clinicians

Practice addresses (Care Compare)

16260 Ventura Blvd
Suite 705
Encino, CA 91436-5101
Phone (818) 995-7500

2677 Zoe Ave
Suite 201
Huntington Park, CA 90255-4195
Phone (323) 589-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT9920CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaminsky Physical Therapy, Inc. CurrentSince Apr 18, 2023 Accepting new patients
California Luna Care Physical Therapy PC Orthopedic CurrentSince Feb 10, 2022 Accepting new patients

Locations

16260 Ventura Blvd
Ste 705
Encino, CA 91436
Phone (818) 995-7500

6601 Rugby Ave
Ste 401
Huntington Pk, CA 90255
Phone (323) 589-5000

6360 Wilshire Blvd
Ste 301
Los Angeles, CA 90048
Phone (323) 966-2676

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821184946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 CRENSHAW BLVD STE 103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905010424",
            "telephone_number": "310-320-6659",
            "fax_number": "310-320-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 CRENSHAW BLVD STE 103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905010424",
            "telephone_number": "310-320-6659",
            "fax_number": "310-320-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBORO",
        "first_name": "STEVEN",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT9920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.