NPIMap

Organization Active NPI

Advanced Integrative Rehabilitation

  • Physical Therapy Clinic/Center
  • Capitola, CA
National Provider Identifier
1902132012
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
35404 Issued in CA
Legal business name
ADVANCED INTEGRATIVE REHABILITATION
Practice address
1200 41St Ave Ste H
Capitola, CA 95010-3900
Phone
(831) 346-6886
Fax
(831) 346-6884
NPI assigned
Oct 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Christopher VafiadesNPI 1780827170
Title
Physical Therapist/ President
Phone
(831) 346-6886

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 35404 CA Primary

Addresses

Primary practice location

1200 41St Ave Ste H
Capitola, CA 95010-3900

Mailing address

1200 41St Ave Ste H
Capitola, CA 95010-3900
Phone (831) 346-6886

Other practice location 1

545 Frederick Street
Santa Cruz, CA 95062-2239
Phone (831) 426-4325

Other names 2

  • FYZICAL Santa Cruz Doing business as
  • FYZICAL Therapy and Balance Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130117000239 CA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183877459 Receives reassigned benefits from 7 practitioners
Practice locations: Capitola, CA

National Provider Directory

National Provider Directory

Locations

1200 41st Ave
Ste H
Capitola, CA 95010
Phone (831) 346-6886

545 Frederick St
Santa Cruz, CA 95062
Phone (831) 426-4325

4700 Soquel Dr
Soquel, CA 95073
Phone (831) 888-9410

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1902132012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 41ST AVE STE H",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103900",
            "telephone_number": "831-346-6886",
            "fax_number": "831-346-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 41ST AVE STE H",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103900",
            "telephone_number": "831-346-6886",
            "fax_number": "831-346-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Frederick Street",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950622239",
            "country_code": "US",
            "telephone_number": "831-426-4325",
            "fax_number": "831-426-4327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED INTEGRATIVE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-23",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "VAFIADES",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/ PRESIDENT",
        "authorized_official_telephone_number": "831-346-6886"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "35404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL Santa Cruz",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FYZICAL Therapy and Balance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.