Individual provider Active NPI

Wayne Chen, DPT

  • Physical Therapist
  • Garden Grove, CA
National Provider Identifier
1821578287
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT295162 Issued in CA
Practice address
12465 Lewis St Ste 101
Garden Grove, CA 92840-4658
Phone
(714) 703-8477
Fax
(714) 703-8157
NPI assigned
Aug 15, 2018
Last updated
Apr 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 PT295162 CA Primary

Addresses

Primary practice location

12465 Lewis St Ste 101
Garden Grove, CA 92840-4658

Mailing address

12465 Lewis St Ste 101
Garden Grove, CA 92840-4658
Phone (714) 703-8477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181008002671 CA Practitioner - Physical Therapist in Private Practice 2668724378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascend Laguna Woods Physical Therapy IncGroup PAC ID 2769927482, 4 clinicians

Practice addresses (Care Compare)

24361 El Toro Rd
Suite 140
Laguna Woods, CA 92637-8898
Phone (949) 694-9988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT295162CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Physical Therapy, Inc Physical Therapist CurrentSince Aug 7, 2018 Accepting new patients
Ascend Laguna Woods Physical Therapy, Inc Physical Therapist CurrentSince Mar 22, 2024 Accepting new patients
Innovative Management Inc CurrentSince Aug 7, 2018 Accepting new patients

Locations

12465 Lewis St
Ste 101
Garden Grove, CA 92840
Phone (714) 703-8477

24361 El Toro Rd
Ste 140
Laguna Woods, CA 92637
Phone (949) 540-7560

Organizations & group practices 3

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": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1821578287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "WAYNE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-15",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT295162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.