Individual provider Active NPI

Monica C Jimenez, PT

  • Physical Therapist
  • San Marcos, CA
National Provider Identifier
1952446650
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT33505 Issued in CA
Practice address
2115 Montiel Rd Ste 103
San Marcos, CA 92069-3587
Phone
(760) 839-2905
Fax
(760) 839-2901
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 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 PT33505 CA Primary

Addresses

Primary practice location

2115 Montiel Rd Ste 103
San Marcos, CA 92069-3587

Mailing address

3760 Convoy St Ste 101
San Diego, CA 92111-3743
Phone (888) 208-8526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000529 CA Practitioner - Physical Therapist in Private Practice 3476658212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

1020 Tierra del Rey
Suite a 1
Chula Vista, CA 91910-7886
Phone (619) 585-7104

2115 Montiel Rd
Suite 103
San Marcos, CA 92069-3587
Phone (760) 839-2905

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Feb 13, 2007 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Feb 13, 2007 Accepting new patients

Locations

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

3760 Convoy St
Ste 101
San Diego, CA 92111
Phone (858) 264-1434

2115 Montiel Rd
Ste 103
San Marcos, CA 92069
Phone (760) 738-8190

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1952446650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "888-208-8526",
            "fax_number": "858-751-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 MONTIEL RD STE 103",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920693587",
            "telephone_number": "760-839-2905",
            "fax_number": "760-839-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "MONICA",
        "middle_name": "C",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT33505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.