Glen Carlos Swoopes, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT24029 Issued in CA

Practice address

633 Hawkins Way
Santa Maria, CA 93455-7427

Phone

(805) 598-6982

NPI assigned

Sep 18, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Coastal Therapy LLC

  • Physical Therapist
  • Santa Maria, CA
  • NPI 1710750344

  Orthopedic

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1962280404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 HAWKINS WAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934557427",
            "telephone_number": "805-598-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 HAWKINS WAY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934557427",
            "telephone_number": "805-598-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWOOPES",
        "first_name": "GLEN",
        "middle_name": "CARLOS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT24029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Kenta Suzuki
• Juliana Beth Sveen, MFT
• Allan Dale Swanson, AS HUMAN SERVICES
• Sara Swart
• Mitchell Switalski
• Mellissa Sydney, DO
• Kristopher William Szalonek, M.P.T
• Tiffany Ta, PHARM.D
• Christopher Allen Tabamo, PHARMD
• Maria Guadalupe Tachiquin, RN

• Orthopedic Physical Therapist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.