Individual provider Active NPI

Rachel Iwata, RPT

  • Physical Therapist
  • Seal Beach, CA
National Provider Identifier
1821490616
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41616 Issued in CA
Practice address
12501 Seal Beach Blvd
Ste 210
Seal Beach, CA 90740-2763
Phone
(562) 493-8800
Fax
(562) 493-2980
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT41616 CA Primary

Addresses

Primary practice location

12501 Seal Beach Blvd
Ste 210
Seal Beach, CA 90740-2763

Mailing address

12501 Seal Beach Blvd
Ste 210
Seal Beach, CA 90740-2763
Phone (562) 493-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150121002195 CA Practitioner - Physical Therapist in Private Practice 8729302781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41616CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Praxis Physical Therapy, Inc. Physical Therapist CurrentSince Apr 1, 2019 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jul 31, 2024 Accepting new patients

Locations

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

1360 W 6th St
Ste 210
San Pedro, CA 90732
Phone (310) 548-3130

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1821490616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 SEAL BEACH BLVD",
            "address_2": "STE 210",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402763",
            "telephone_number": "562-493-8800",
            "fax_number": "562-493-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 SEAL BEACH BLVD",
            "address_2": "STE 210",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402763",
            "telephone_number": "562-493-8800",
            "fax_number": "562-493-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWATA",
        "first_name": "RACHEL",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT41616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seal Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.