Individual provider Active NPI

Eric Dewhirst, RPT

  • Physical Therapist
  • Long Beach, CA
National Provider Identifier
1871676429
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT23963 Issued in CA
Practice address
2760 Atlantic Ave
Long Beach, CA 90806-2755
Phone
(562) 424-5198
Fax
(562) 427-1235
NPI assigned
Oct 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT23963 CA Primary

Addresses

Primary practice location

2760 Atlantic Ave
Long Beach, CA 90806-2755

Mailing address

22619 Kathryn Ave
Torrance, CA 90505-3401
Phone (310) 373-3236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041001000571 CA Practitioner - Physical Therapist in Private Practice 2961471354 Reassigns benefits to 1 organization

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
Peninsula Physical Therapy Inc.Group PAC ID 2860679065, 8 clinicians

Practice addresses (Care Compare)

550 Deep Valley Dr
Suite 297
Rolling Hills Estates, CA 90274-3698
Phone (310) 544-6264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT23963CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Physical Therapy Inc. Physical Therapist CurrentSince Jan 16, 2017 Accepting new patients
Pacific Physical Therapy Physical Therapist PastSince Jan 16, 2017 Accepting new patients

Locations

550 Deep Valley Dr
Ste 297
Rolling Hills Estates, CA 90274
Phone (310) 544-6264

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, 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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871676429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22619 KATHRYN AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905053401",
            "telephone_number": "310-373-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062755",
            "telephone_number": "562-424-5198",
            "fax_number": "562-427-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWHIRST",
        "first_name": "ERIC",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT23963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.