Individual provider Active NPI

Jacob Greenfield, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1942030879
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
306487 Issued in CA
Practice address
4060 4TH Ave Ste 206
San Diego, CA 92103-2120
Phone
(619) 299-5246
NPI assigned
Aug 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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 306487 CA Primary

Addresses

Primary practice location

4060 4TH Ave Ste 206
San Diego, CA 92103-2120

Mailing address

4420 Cleveland Ave Apt 9
San Diego, CA 92116-3914
Phone (530) 919-0085

Other practice location 1

4094 4th Ave
San Diego, CA 92103-2143
Phone (619) 515-2545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911003106 CA Practitioner - Physical Therapist in Private Practice 0042750465 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
306487CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Physical Therapy Current Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Feb 10, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Feb 10, 2025 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist CurrentSince Aug 5, 2024 Accepting new patients
Eggleton Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients
Eggleton & Langton Physical Therapy Management Services Physical Therapist Past Accepting new patients

Locations

2536 Rockwood Ave
Calexico, CA 92231
Phone (760) 768-3422

2437 Fenton St
Ste B
Chula Vista, CA 91914
Phone (619) 656-5176

317 N El Camino Real
Ste 210
Encinitas, CA 92024
Phone (760) 337-1144

5905 Severin Dr
La Mesa, CA 91942
Phone (619) 589-2606

4060 4th Ave
Ste 206
San Diego, CA 92103
Phone (619) 297-0014

2650 Camino del Rio N
Ste 200
San Diego, CA 92108
Phone (619) 295-3000

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545

10225 Austin Dr
Ste 204
Spring Valley, CA 91978
Phone (619) 670-4567

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1942030879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 CLEVELAND AVE APT 9",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921163914",
            "telephone_number": "530-919-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 4TH AVE STE 206",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032120",
            "telephone_number": "619-299-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4094 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921032143",
            "country_code": "US",
            "telephone_number": "619-515-2545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "JACOB",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306487",
            "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 Jan 20, 2025; 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.