Individual provider Active NPI

Heather Leigh Haworth, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1952732018
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40713 Issued in CA
Practice address
3760 Convoy St Ste 100
San Diego, CA 92111-3743
Phone
(858) 573-9368
Fax
(858) 874-0582
NPI assigned
Nov 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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 40713 CA Primary

Addresses

Primary practice location

3760 Convoy St Ste 100
San Diego, CA 92111-3743

Mailing address

3760 Convoy St Ste 100
San Diego, CA 92111-3743
Phone (858) 573-9368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140319001570 CA Practitioner - Physical Therapist in Private Practice 9931330719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Life Physical Therapy Services PCGroup PAC ID 7214207125, 94 clinicians

Practice addresses (Care Compare)

2404 Loring St
San Diego, CA 92109-2347
Phone (858) 581-8574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40713CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Es3 Physical Therapy Inc CurrentSince Jul 26, 2021 Accepting new patients
New Life Physical Therapy Services, PC Physical Therapist CurrentSince Sep 23, 2024 Accepting new patients

Locations

10425 Tierrasanta Blvd
Ste 102
San Diego, CA 92124
Phone (858) 598-5055

2404 Loring St
San Diego, CA 92109
Phone (858) 252-2700

12515 Springhurst Dr
San Diego, CA 92128
Phone (858) 771-3694

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": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1952732018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-573-9368",
            "fax_number": "858-874-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-573-9368",
            "fax_number": "858-874-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWORTH",
        "first_name": "HEATHER",
        "middle_name": "LEIGH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40713",
            "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 Jun 22, 2021; 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.