Individual provider Active NPI

Prashant Jaiswal

  • Physical Therapist
  • West Covina, CA
National Provider Identifier
1922751734
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT303961 Issued in CA
Practice address
100 N Barranca St Ste 920
West Covina, CA 91791-1654
Phone
(626) 263-6469
Fax
(626) 332-5298
NPI assigned
Feb 1, 2022
Last updated
Feb 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048018-01 NY
Physical Therapist 225100000X PT303961 CA Primary

Addresses

Primary practice location

100 N Barranca St Ste 920
West Covina, CA 91791-1654

Mailing address

851 S Sunset Ave
West Covina, CA 91790-5510
Phone (203) 997-1208

Other practice location 1

1850 N Riverside Ave Ste 240
Rialto, CA 92376-8082
Phone (909) 258-2220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403000195 CA Practitioner - Physical Therapist in Private Practice 9133567605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transit Physical Therapy PCGroup PAC ID 3274899315, 26 clinicians

Practice addresses (Care Compare)

1850 N Riverside Ave
Suite 240
Rialto, CA 92376-8082
Phone (909) 258-2220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT303961CAMDPhysical Therapist
048018-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transit Physical Therapy PC Physical Therapist CurrentSince Feb 13, 2024 Accepting new patients

Locations

1850 N Riverside Ave
Ste 240
Rialto, CA 92376
Phone (909) 258-2220

275 W Hospitality Ln
Ste 102
San Bernardino, CA 92408
Phone (909) 567-2221

275 W Hospitality Ln
Ste 103
Sn Bernrdno, CA 92408
Phone (909) 567-2221

100 N Barranca St
Ste 920
West Covina, CA 91791
Phone (626) 263-6469

Organizations & group practices 1

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": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1922751734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917905510",
            "telephone_number": "203-997-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N BARRANCA ST STE 920",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911654",
            "telephone_number": "626-263-6469",
            "fax_number": "626-332-5298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 N Riverside Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923768082",
            "country_code": "US",
            "telephone_number": "909-258-2220",
            "fax_number": "909-258-2102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAISWAL",
        "first_name": "PRASHANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048018-01",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT303961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.