Individual provider Active NPI

Urmila Adusumalli, PT

  • Physical Therapist
  • Cerritos, CA
National Provider Identifier
1871776153
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30398 Issued in CA
Practice address
13736 Aclare St
Cerritos, CA 90703-1005
Phone
(909) 657-8097
NPI assigned
Dec 10, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 30398 CA Primary

Addresses

Primary practice location

13736 Aclare St
Cerritos, CA 90703-1005

Mailing address

13736 Aclare St
Cerritos, CA 90703-1005

Other practice location 1

7997 Glide Path Ct
Chino, CA 91708-7616
Phone (714) 442-7963

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180323001120 CA Practitioner - Physical Therapist in Private Practice 2860753142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Wave Physical Therapy IncGroup PAC ID 1153682430, 2 clinicians

Practice addresses (Care Compare)

3851 Katella Ave
Suite 365
Los Alamitos, CA 90720-3392
Phone (562) 334-5398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30398CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
New Wave Physical Therapy Inc Physical Therapist CurrentSince Feb 15, 2018 Accepting new patients

Locations

3851 Katella Ave
Ste 365
Los Alamitos, CA 90720
Phone (562) 296-8107

Organizations & group practices 1

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": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871776153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13736 ACLARE ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13736 ACLARE ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031005",
            "telephone_number": "909-657-8097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7997 Glide Path Ct",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917087616",
            "country_code": "US",
            "telephone_number": "714-442-7963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADUSUMALLI",
        "first_name": "URMILA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "30398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.