Maryam Hamidi, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

24838 Issued in CA

Practice address

777 Corporate Dr Ste 160
Ladera Ranch, CA 92694-2136

Phone

(949) 545-7007

Fax

(833) 278-1932

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (1 of 2)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Empower Physical Therapy & Aquatics Institute

  • Physical Therapist
  • Ladera Ranch, CA
  • NPI 1093200222

  CA, Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1891738639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CORPORATE DR STE 160",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942136",
            "telephone_number": "949-545-7007",
            "fax_number": "833-278-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CORPORATE DR STE 160",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942136",
            "telephone_number": "949-545-7007",
            "fax_number": "833-278-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMIDI",
        "first_name": "MARYAM",
        "name_prefix": "Mrs.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT24838",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "24838",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "24838",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "24838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ann Gordon
• Kimberly Rivera Gress, DDS
• Bettina A Grillo
• Tyler Hales, DDS
• Sogol Safarian Hamedany
• Samara Elias Hanna
• Shani Hans
• Stephen Harkins, D.C.
• Harmony Behavioral Center Inc
• Grace Elizabeth Harris

• All providers in Ladera Ranch, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.