Individual provider Active NPI

Joluis De Los Santos, DPT

  • Physical Therapist
  • Irvington, NY
National Provider Identifier
1881240125
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297795 Issued in CA
Practice address
1 Bridge St Ste 71
Irvington, NY 10533-1560
Phone
(914) 478-0608
NPI assigned
Aug 13, 2019
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 297795 CA Primary
Physical Therapist 225100000X 044481 NY

Addresses

Primary practice location

1 Bridge St Ste 71
Irvington, NY 10533-1560

Mailing address

1035 Aviation Blvd
Hermosa Beach, CA 90254-4023
Phone (310) 937-2323

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305000731 CA Practitioner - Physical Therapist in Private Practice 8729317177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Evolution Physical Therapy IncGroup PAC ID 0244336964, 72 clinicians

Practice addresses (Care Compare)

12703 Cerise Ave
Hawthorne, CA 90250-4805
Phone (424) 297-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Physical Therapy, Inc Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Aim Sports Medicine and Physical Therapy Inc Single Specialty CurrentSince Nov 27, 2019 Accepting new patients
Frank E Kaden D C Chiropractic Inc Single Specialty CurrentSince Nov 27, 2019 Accepting new patients
Next Phase Medical PC Single Specialty PastSince Sep 28, 2025 Accepting new patients
Holt Chiropractic Offices, P.C. Single Specialty Past Accepting new patients

Locations

12703 Cerise Ave
Hawthorne, CA 90250
Phone (424) 297-3600

1035 Aviation Blvd
Hermosa Beach, CA 90254
Phone (310) 251-0862

11825 Major St
Ste 107
Los Angeles, CA 90230
Phone (310) 915-6100

322 Culver Blvd
Playa del Rey, CA 90293
Phone (310) 779-9712

Organizations & group practices 5

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": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1881240125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 AVIATION BLVD",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902544023",
            "telephone_number": "310-937-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRIDGE ST STE 71",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105331560",
            "telephone_number": "914-478-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS SANTOS",
        "first_name": "JOLUIS",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297795",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.