Individual provider Active NPI

Tatiana Nazaroff

  • Physical Therapist
  • Torrance, CA
National Provider Identifier
1821621665
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT298084 Issued in CA
Practice address
23430 Hawthorne Blvd
Torrance, CA 90505-4720
Phone
(310) 465-4243
NPI assigned
Feb 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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 PT298084 CA Primary

Addresses

Primary practice location

23430 Hawthorne Blvd
Torrance, CA 90505-4720

Mailing address

825 Chestnut St
La Habra, CA 90631-3008
Phone (562) 447-7401

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230222001520 CA Practitioner - Physical Therapist in Private Practice 4385017318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohana Physical Therapy IncGroup PAC ID 7911972906, 6 clinicians

Practice addresses (Care Compare)

13341 Garden Grove Blvd
Suite B
Garden Grove, CA 92843-2255
Phone (714) 750-4097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT298084CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohana Physical Therapy Inc Physical Therapist CurrentSince Feb 15, 2023 Accepting new patients

Locations

13341 Garden Grove Blvd
Ste B
Garden Grove, CA 92843
Phone (310) 649-5381

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1821621665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHESTNUT ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906313008",
            "telephone_number": "562-447-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23430 HAWTHORNE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054720",
            "telephone_number": "310-465-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZAROFF",
        "first_name": "TATIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT298084",
            "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 Feb 20, 2020; 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.