NPIMap

Organization Active NPI

Bewell Home Physical Therapy P C

  • Physical Therapy Clinic/Center
  • San Marcos, CA
National Provider Identifier
1831582592
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BEWELL HOME PHYSICAL THERAPY P C
Practice address
1582 W San Marcos Blvd Ste 105B
San Marcos, CA 92078
Phone
(650) 452-4110
NPI assigned
Mar 5, 2015
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kyoko YamadaNPI 1497071237
Title
Director
Phone
(650) 452-4110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1582 W San Marcos Blvd Ste 105B
San Marcos, CA 92078

Mailing address

3011 44TH St
San Diego, CA 92105-4316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150603000343 CA Part B Supplier - Clinic/Group Practice 9335460351 Receives reassigned benefits from 20 practitioners
Practice locations: San Marcos, CA

National Provider Directory

National Provider Directory

Locations

1582 W San Marcos Blvd
Ste 105B
San Marcos, CA 92078
Phone (650) 452-4110

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1831582592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 44TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921054316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1582 W SAN MARCOS BLVD STE 105B",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "92078",
            "telephone_number": "650-452-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEWELL HOME PHYSICAL THERAPY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "YAMADA",
        "authorized_official_first_name": "KYOKO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "650-452-4110"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.

Verify at the official NPI Registry.