Individual provider Active NPI

Sanford Sheklow, PT

  • Physical Therapist
  • La Canada, CA
National Provider Identifier
1881792000
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14276 Issued in CA
Practice address
1346 Foothill Blvd
Suite 101
La Canada, CA 91011-2122
Phone
(818) 790-3001
Fax
(818) 790-9732
NPI assigned
Sep 20, 2006
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 PT14276 CA Primary

Addresses

Primary practice location

1346 Foothill Blvd
Suite 101
La Canada, CA 91011-2122

Mailing address

3434 Markridge Rd
La Crescenta, CA 91214-1137
Phone (818) 790-3001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120703000424 CA Practitioner - Physical Therapist in Private Practice 8123913993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DSC Physical Therapy Inc.Group PAC ID 1052206810, 2 clinicians

Practice addresses (Care Compare)

1346 Foothill Blvd
La Canada, CA 91011-2131
Phone (818) 790-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT14276CAMDPhysical Therapist
14276CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
DSC Physical Therapy Inc. Physical Therapist CurrentSince Apr 4, 2005 Accepting new patients

Locations

410 Arden Ave
Ste 102
Glendale, CA 91203
Phone (818) 240-0803

1346 Foothill Blvd
Ste 101
La Canada Flt, CA 91011
Phone (818) 790-3001

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881792000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 MARKRIDGE RD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912141137",
            "telephone_number": "818-790-3001",
            "fax_number": "818-790-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 FOOTHILL BLVD",
            "address_2": "SUITE 101",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112122",
            "telephone_number": "818-790-3001",
            "fax_number": "818-790-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEKLOW",
        "first_name": "SANFORD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT14276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, 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.