Individual provider Active NPI

Brian Sandoval

  • Physical Therapist
  • Santa Clarita, CA
National Provider Identifier
1841716487
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
17866 Sierra Hwy # 101
Santa Clarita, CA 91351-1637
Phone
(661) 347-9029
NPI assigned
Aug 15, 2017
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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 Primary

Addresses

Primary practice location

17866 Sierra Hwy # 101
Santa Clarita, CA 91351-1637

Mailing address

14126 Herron St
Sylmar, CA 91342-4113

Other practice location 1

23206 Lyons Ave Ste 105
Newhall, CA 91321-2671
Phone (661) 383-9828

Other practice location 2

11819 Wilshire Blvd
Los Angeles, CA 90025-6619
Phone (323) 936-7525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171128003171 CA Practitioner - Physical Therapist in Private Practice 3678830718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Next Level Physical Therapy and Athletic Performance PCGroup PAC ID 6507116852, 5 clinicians

Practice addresses (Care Compare)

23206 Lyons Ave
Suite 105
Santa Clarita, CA 91321-2671
Phone (661) 383-9828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Next Level Physical Therapy and Athletic Performance, PC Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Body Rehab Center Physical Therapist PastSince Nov 20, 2017 Accepting new patients
Vargo Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Locations

17866 Sierra Hwy
Ste 101
Santa Clarita, CA 91351
Phone (661) 343-9029

23206 Lyons Ave
Ste 105
Santa Clarita, CA 91321
Phone (661) 288-0081

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1841716487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14126 HERRON ST",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913424113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17866 SIERRA HWY # 101",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913511637",
            "telephone_number": "661-347-9029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23206 Lyons Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Newhall",
            "state": "CA",
            "postal_code": "913212671",
            "country_code": "US",
            "telephone_number": "661-383-9828",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11819 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900256619",
            "country_code": "US",
            "telephone_number": "323-936-7525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.