Joluis De Los Santos, DPT
Individual provider Active NPI Physical Therapist · Irvington, NY
NPI 1881240125 · NPPES record last updated Feb 11, 2020
Key facts
- NPI
- 1881240125
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 297795 (CA)
- Practice address
- 1 Bridge St Ste 71
Irvington, NY 10533-1560 - Phone
- (914) 478-0608
- NPI assigned
- Aug 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Evolution Physical Therapy Inc
Practice addresses (Care Compare)
12703 Cerise Ave
Hawthorne, CA 90250-4805
Phone (424) 297-3600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200305000731 | CA | Practitioner - Physical Therapist in Private Practice | 8729317177 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 297795 | CA | MD | Physical Therapist |
| 044481 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aim Sports Medicine and Physical Therapy Inc | Single Specialty | Current |
Accepting new patients |
| Frank E Kaden D C Chiropractic Inc | Single Specialty | Current |
Accepting new patients |
| Evolution Physical Therapy, Inc | Physical Therapist | Current |
Accepting new patients |
| Holt Chiropractic Offices, P.C. | Single Specialty | Past | Accepting new patients |
| Next Phase Medical PC | 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) 461-8712
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 297795 | CA | Yes |
| 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
Other providers in Irvington, NY
- Connie Douglas LCSW
- Ebony Cooper
- Tania Cruz
- Amber Dasilva
- Lynita Davis
- Dominick Frank Difabio
- Dominick Cannavo Anesthesiology Consulting PC
- Danielle Dowe
- Kevin Doyle
- Dr. David Ashe MD
All providers in Irvington, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.