Individual provider Active NPI

Ronald D Waltman, PT, DPT

  • Physical Therapist
  • Lake Forest, CA
National Provider Identifier
1922540061
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT292359 Issued in CA
Practice address
22600 Lambert St Ste 1202F
Lake Forest, CA 92630-1623
Phone
(949) 345-1696
NPI assigned
Nov 7, 2016
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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 PT292359 CA Primary

Addresses

Primary practice location

22600 Lambert St Ste 1202F
Lake Forest, CA 92630-1623

Mailing address

1964 San Bruno
Newport Beach, CA 92660-4536
Phone (949) 345-1696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161130002027 CA Practitioner - Physical Therapist in Private Practice 8022398429 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT292359CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 7, 2020 Accepting new patients
Kinetix Performance Physical Therapy, Inc. CurrentSince Jan 19, 2025 Accepting new patients
Mesisca Physical Therapy Inc Physical Therapist CurrentSince Aug 17, 2020 Accepting new patients
Southland Physical Therapy Mission Viejo Clinic, PC Physical Therapist PastSince Sep 1, 2019 Accepting new patients
Reo Physical Therapy PastSince Mar 31, 2024 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Past Accepting new patients
JM Physical Therapy Inc Physical Therapist Past Accepting new patients
Southland Physical Therapy, Inc. Physical Therapist PastSince Dec 18, 2014 Accepting new patients

Locations

30025 Alicia Pkwy
Laguna Niguel, CA 92677
Phone (714) 231-0169

22600 Lambert St
Ste 1202F
Lake Forest, CA 92630
Phone (949) 345-1696

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1922540061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 SAN BRUNO",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604536",
            "telephone_number": "949-345-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 LAMBERT ST STE 1202F",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301623",
            "telephone_number": "949-345-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTMAN",
        "first_name": "RONALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PT,  DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-07",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT292359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.