Individual provider Active NPI

Nathan Burlakovsky

  • Physical Therapist
  • La Mesa, CA
National Provider Identifier
1891226437
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292923 Issued in CA
Practice address
5905 Severin Dr
La Mesa, CA 91942-3806
Phone
(619) 589-2606
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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 292923 CA Primary

Addresses

Primary practice location

5905 Severin Dr
La Mesa, CA 91942-3806

Mailing address

5905 Severin Dr
La Mesa, CA 91942-3806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428000637 CA Practitioner - Physical Therapist in Private Practice 0143507111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

88 E Bonita Rd
Suite C
Chula Vista, CA 91910-3057
Phone (619) 230-0855

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
292923CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Orthopedic Specialists, Inc. Physical Therapy CurrentSince Nov 18, 2019 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Nov 18, 2019 Accepting new patients
Eggleton Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

88 E Bonita Rd
Ste C
Chula Vista, CA 91910
Phone (619) 230-0855

8388 Parkway Dr
La Mesa, CA 91942
Phone (619) 439-6878

4700 Spring St
Ste 180
La Mesa, CA 91942
Phone (619) 383-0704

3750 Convoy St
Ste 201B
San Diego, CA 92111
Phone (858) 302-2499

4445 Eastgate Mall
Ste 103
San Diego, CA 92121
Phone (858) 450-7118

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1891226437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5905 SEVERIN DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 SEVERIN DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423806",
            "telephone_number": "619-589-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLAKOVSKY",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; 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.