Individual provider Active NPI

Mikaela Amble

  • Physical Therapist
  • Santa Barbara, CA
National Provider Identifier
1962028324
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5152 Hollister Ave
Santa Barbara, CA 93111-2550
Phone
(805) 681-9108
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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 Primary

Addresses

Primary practice location

5152 Hollister Ave
Santa Barbara, CA 93111-2550

Mailing address

3801 La Cumbre Hills LN
Santa Barbara, CA 93110-4506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925000462 CA Practitioner - Physical Therapist in Private Practice 1355760323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Rehabilitation Center, Inc.Group PAC ID 5193804276, 12 clinicians

Practice addresses (Care Compare)

5152 Hollister Ave
Santa Barbara, CA 93111-2550
Phone (805) 681-9108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Rehabilitation Center, Inc. Physical Therapist CurrentSince Aug 10, 2020 Accepting new patients

Locations

5152 Hollister Ave
Santa Barbara, CA 93111
Phone (805) 681-9108

121 Gray Ave
Ste 100
Santa Barbara, CA 93101
Phone (805) 681-9108

Organizations & group practices 1

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": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1962028324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LA CUMBRE HILLS LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931104506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5152 HOLLISTER AVE",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931112550",
            "telephone_number": "805-681-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBLE",
        "first_name": "MIKAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.