Individual provider Active NPI

Victor Ramon Carlos, DPT

  • Physical Therapist
  • Laguna Hills, CA
National Provider Identifier
1952362964
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT26966 Issued in CA
Practice address
24012 Calle de la Plata
200
Laguna Hills, CA 92653-3621
Phone
(949) 583-9251
Fax
(949) 583-9246
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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 PT26966 CA Primary

Addresses

Primary practice location

24012 Calle de la Plata
200
Laguna Hills, CA 92653-3621

Mailing address

22311 Brookhurst St
Unit 8
Huntington Beach, CA 92646-8450
Phone (714) 965-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000500 CA Practitioner - Physical Therapist in Private Practice 5799729935 Practice locations: Huntington Beach, CA

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

Practice addresses (Care Compare)

22311 Brookhurst St
Suite 104
Huntington Beach, CA 92646-8458
Phone (714) 594-3690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT26966CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Physical Therapy and Sports Center Physical Therapist Past Accepting new patients
Therapro Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1952362964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22311 BROOKHURST ST",
            "address_2": "UNIT 8",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926468450",
            "telephone_number": "714-965-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA",
            "address_2": "200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533621",
            "telephone_number": "949-583-9251",
            "fax_number": "949-583-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "VICTOR",
        "middle_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.