Roshan Kottayadiyil Varghese

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303260 Issued in CA

Practice address

425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495

Phone

(951) 674-9517

Fax

(951) 674-9517

NPI assigned

Feb 9, 2023

Last updated

Nov 13, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MDRS Spine & Sport, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1952394603

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• All Star Physical Therapy

  • Physical Therapist
  • Murrieta, CA
  • NPI 1750559431
  Medicare reassignment NPD
• Rehab Specialists Outpatient, LLC

  dba AgeRight Therapy Paradise Village

  • Clinic/Center
  • National City, CA
  • NPI 1235868381

  Physical Therapist

  Medicare reassignment NPD
• MDRS Spine & Sport, Inc

  • Physical Therapist
  • Temecula, CA
  • NPI 1689824203
  NPD
• Rehab Specialists Outpatient, LLC

  dba AgeRight Therapy Hope Village

  • Clinic/Center
  • Canby, OR
  • NPI 1437019015

  Physical Therapist

  NPD
• Bewell Home Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Malvern, PA
  • NPI 1942791603
  NPD (past)

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1912604083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "951-335-9825",
            "fax_number": "812-590-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DIAMOND DR STE 101",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304495",
            "telephone_number": "951-674-9517",
            "fax_number": "951-674-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGHESE",
        "first_name": "ROSHAN",
        "middle_name": "KOTTAYADIYIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Valiente
• Ryan David Valle
• Marrissa Vance
• Crystal Vandervort
• Jeffery A Vandyke, C.A.S.
• Diana Laura Vasquez
• Anna Marie Vaughn
• Gabriela Vazquez
• Ailyn Vega
• Vanessa Velazquez

• Physical Therapist in Lake Elsinore, CA
• Providers in Lake Elsinore, 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 13, 2023; 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.