Jesse Stallworth Smith, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1392 E Palomar St Ste 503
Chula Vista, CA 91913-1895

Phone

(619) 482-3000

NPI assigned

Feb 28, 2023

Last updated

Nov 18, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Plus Physical Therapy, Inc.Group PAC ID 1850668773, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Performance Plus Physical Therapy, Inc.

  • Physical Therapist
  • Chula Vista, CA
  • NPI 1144766064
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1902505910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 IDAHO ST UNIT F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042562",
            "telephone_number": "619-482-3000",
            "fax_number": "619-482-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 E PALOMAR ST STE 503",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131895",
            "telephone_number": "619-482-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 Smithtown Blvd",
            "address_purpose": "LOCATION",
            "city": "Nesconset",
            "state": "NY",
            "postal_code": "117671859",
            "country_code": "US",
            "telephone_number": "631-979-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JESSE",
        "middle_name": "STALLWORTH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-28",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "048805-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Camiya Smith
• Carmen Rae Smith, OTD, OTR/L
• Consuelo Smith
• Danielle Smith
• Emma Louise Smith
• Kaitlin Maret Smith
• Mary Kay Smith, CATCI
• Paxton Christopher Smith
• Robin Victor Smith, M.D.
• Ronald Laurence Smith

• Physical Therapist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.