Active NPI
Samuel Moisenco
- Physical Therapist
- Santa Barbara, CA
National Provider Identifier
1821718602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT303076
- Practice address
- 41 Hitchcock Way
Santa Barbara, CA 93105-3174 - Phone
- (805) 682-2536
- Fax
- (805) 682-1281
- NPI assigned
- Aug 31, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT303076 | CA | Primary |
Addresses
Primary practice location
41 Hitchcock Way
Santa Barbara, CA 93105-3174
Mailing address
41 Hitchcock Way
Santa Barbara, CA 93105-3174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221208001587 | CA | Practitioner - Physical Therapist in Private Practice | 8628447935 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT303076 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1821718602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 HITCHCOCK WAY",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931053174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 HITCHCOCK WAY",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931053174",
"telephone_number": "805-682-2536",
"fax_number": "805-682-1281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOISENCO",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-31",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT303076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.