Individual provider Active NPI

Ericka Craft Mizuta, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1932218567
Registry record updated Feb 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29228 Issued in CA
Practice address
2555 Camino del Rio S Ste 102
San Diego, CA 92108-3704
Phone
(619) 599-8292
Fax
(619) 599-8292
NPI assigned
Aug 29, 2006
Last updated
Feb 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2009

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 29228 CA Primary

Addresses

Primary practice location

2555 Camino del Rio S Ste 102
San Diego, CA 92108-3704

Mailing address

8281 Polizzi PL
San Diego, CA 92123-3830
Phone (804) 475-6853

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706000524 CA Practitioner - Physical Therapist in Private Practice 0648255083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mizuta and Associates Physical Therapy IncGroup PAC ID 2163572629, 5 clinicians

Practice addresses (Care Compare)

8281 Polizzi PL
San Diego, CA 92123-3830
Phone (619) 564-7120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mizuta & Associates Physical Therapy, Inc. CurrentSince Aug 23, 2012 Accepting new patients
Personally Fit Inc Physical Therapist PastSince Jan 18, 2021 Accepting new patients
Stac Physical Therapy Pfi, Inc Physical Therapist PastSince Feb 24, 2022 Accepting new patients
Krpata Sports Therapy, Inc. Physical Therapist Past Accepting new patients
Performance Physical Therapy and Sports Conditioning, Inc Physical Therapist PastSince Feb 24, 2013 Accepting new patients

Locations

2555 Camino del Rio S
Ste 102
San Diego, CA 92108
Phone (619) 208-8998

Organizations & group practices 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235779200000",
    "number": "1932218567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8281 POLIZZI PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233830",
            "telephone_number": "804-475-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 CAMINO DEL RIO S STE 102",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083704",
            "telephone_number": "619-599-8292",
            "fax_number": "619-599-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUTA",
        "first_name": "ERICKA",
        "middle_name": "CRAFT",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2009; 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.