Individual provider Active NPI

Jennifer Lynn Hart, P.T.

  • Physical Therapist
  • Yorba Linda, CA
National Provider Identifier
1871730416
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 35323 Issued in CA
Practice address
16615 Yorba Linda Blvd
Yorba Linda, CA 92886-2046
Phone
(714) 577-0745
Fax
(714) 577-8653
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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 PT 35323 CA Primary

Addresses

Primary practice location

16615 Yorba Linda Blvd
Yorba Linda, CA 92886-2046

Mailing address

16615 Yorba Linda Blvd
Yorba Linda, CA 92886-2046
Phone (714) 577-0745

Other names 1

  • Jennifer Lynn Demers Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090707000270 CA Practitioner - Physical Therapist in Private Practice 9638220536 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theresa M Locke Physical Therapy IncGroup PAC ID 4284617994, 2 clinicians

Practice addresses (Care Compare)

571 Stanislaus Ave
Suite F
Angels Camp, CA 95222-9354
Phone (209) 736-0956

850 Sanguinetti Rd
Sonora, CA 95370-5280
Phone (209) 928-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 35323CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tuolumne Me-Wuk Indian Health Center, Inc. CurrentSince Jan 20, 2026 Accepting new patients
Theresa M Locke Physical Therapy, Inc Physical Therapist CurrentSince Oct 3, 2023 Accepting new patients
Tuolumne Mewuk Indian Health Center, Inc PastSince Jan 20, 2026 Accepting new patients
Broberg Physical Therapy Physical Therapist Past Accepting new patients

Locations

571 Stanislaus Ave
Ste F
Angels Camp, CA 95222
Phone (209) 736-0956

850 Sanguinetti Rd
Sonora, CA 95370
Phone (209) 694-3870

18880 Cherry Valley Blvd
Tuolumne, CA 95379
Phone (209) 928-5400

Organizations & group practices 4

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1871730416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16615 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862046",
            "telephone_number": "714-577-0745",
            "fax_number": "714-577-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16615 YORBA LINDA BLVD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928862046",
            "telephone_number": "714-577-0745",
            "fax_number": "714-577-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 35323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DEMERS",
            "middle_name": "LYNN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.