Individual provider Active NPI

Brett Richard Vecsey, PT

  • Physical Therapist
  • Santa Monica, CA
National Provider Identifier
1831332097
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26862 Issued in CA
Practice address
1714 17TH St
Santa Monica, CA 90404-4410
Phone
(310) 392-7889
NPI assigned
Apr 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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 PT26862 CA Primary

Addresses

Primary practice location

1714 17TH St
Santa Monica, CA 90404-4410

Mailing address

12975 Agustin PL
#417
Playa Vista, CA 90094-2307
Phone (310) 741-8466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160909001529 OR Practitioner - Physical Therapist in Private Practice 7214087014 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willamette Community Health SolutionsGroup PAC ID 5496667578, shared by 3 NPIs, 30 clinicians

Practice addresses (Care Compare)

89 Centennial Loop
Suite a
Eugene, OR 97401-7917
Phone (541) 342-1632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26862CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icco LLC CurrentSince Sep 1, 2015 Accepting new patients
Willamette Community Health Solutions Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Icco, LLC CurrentSince Sep 1, 2015 Accepting new patients
Willamette Community Health Solutions CurrentSince Feb 1, 2022 Accepting new patients
Blake Physical Therapy, PC Physical Therapist PastSince Dec 16, 2002 Accepting new patients
Willamette Community Health Solutions Past Accepting new patients

Locations

89 Centennial Loop
Ste A
Eugene, OR 97401
Phone (541) 228-3000

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

2650 Suzanne Way
Ste 200
Eugene, OR 97408
Phone (541) 228-3000

Organizations & group practices 6

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1831332097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12975 AGUSTIN PL",
            "address_2": "#417",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942307",
            "telephone_number": "310-741-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 17TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044410",
            "telephone_number": "310-392-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VECSEY",
        "first_name": "BRETT",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.