Individual provider Active NPI

Elyse Valerie Meyer, DPT

  • Physical Therapist
  • Fairfield, CA
National Provider Identifier
1821766726
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
300863 Issued in CA
Practice address
222 Acacia St
Fairfield, CA 94533-3800
Phone
(707) 928-7174
Fax
(707) 434-9725
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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 300863 CA Primary

Addresses

Primary practice location

222 Acacia St
Fairfield, CA 94533-3800

Mailing address

222 Acacia St
Fairfield, CA 94533-3800
Phone (707) 928-7174

Other practice location 1

1009 Alamo Dr
Vacaville, CA 95687-5603
Phone (707) 788-7403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930002644 CA Practitioner - Physical Therapist in Private Practice 2163829334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Body in Balance Physical Therapy IncGroup PAC ID 6608857909, 8 clinicians

Practice addresses (Care Compare)

222 Acacia St
Fairfield, CA 94533-3800
Phone (707) 421-0418

Merit-based Incentive Payment System (MIPS)

Final score
75.98 of 100Reported as group
Quality
55.25
Improvement activities
40
Cost
79.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
300863CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Body in Balance Physical Therapy, Inc. Physical Therapist CurrentSince Aug 26, 2021 Accepting new patients
Golden Bear Physical Therapy Sports Injury Center, Inc Physical Therapist CurrentSince Aug 26, 2021 Accepting new patients

Locations

222 Acacia St
Fairfield, CA 94533
Phone (707) 421-0418

1009 Alamo Dr
Vacaville, CA 95687
Phone (707) 689-5025

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": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1821766726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 ACACIA ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333800",
            "telephone_number": "707-928-7174",
            "fax_number": "707-434-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ACACIA ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333800",
            "telephone_number": "707-928-7174",
            "fax_number": "707-434-9725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 Alamo Dr",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956875603",
            "country_code": "US",
            "telephone_number": "707-788-7403",
            "fax_number": "707-434-9725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "ELYSE",
        "middle_name": "VALERIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "300863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.