Shane Michael Enriquez

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

51442 Issued in CA

Practice address

31271 Niguel Rd Ste J
Laguna Niguel, CA 92677-4135

Phone

(949) 443-5442

Fax

(949) 443-5463

NPI assigned

Sep 15, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Deborah Weinstein Physical Therapy

  • Physical Therapist
  • Laguna Niguel, CA
  • NPI 1881961258
  NPD
• Grace Physical Therapy, Inc.

  • Specialist
  • Laguna Niguel, CA
  • NPI 1386668739
  NPD

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1972273670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7840",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926077840",
            "telephone_number": "949-443-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31271 NIGUEL RD STE J",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774135",
            "telephone_number": "949-443-5442",
            "fax_number": "949-443-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Edwards
• Elder Care Angels of Orange County, Inc.
• Elite Sedation General Partnership
• Andrew Elmasri, DDS
• Michelle Ahn Eng, D.D.S.
• Envision Pediatric Therapy
• Walter Stephen Ernsdorf, PHD
• Santa Adriana Essenberg
• George Valera Estonactoc, PH.D.
• Santiago Estrada, PH.D.

• Physical Therapy Assistant in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.