Jacob Gleason, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT29291 Issued in CA

Practice address

31461 Rancho Viejo Rd
#101
San Juan Capistrano, CA 92675-1864

Phone

(949) 542-5000

Fax

(949) 419-2650

NPI assigned

Jul 14, 2005

Sex

Male

Sole proprietor

No

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, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Fullmotion Physical Therapy PC

  • Physical Therapy Clinic/Center
  • San Juan Capistrano, CA
  • NPI 1831357367
  Medicare reassignment NPD Authorized official
• Gleason Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • San Juan Capistrano, CA
  • NPI 1366771602
  NPD (past) Authorized official
• Sports Medicine Institute South Orange County

  • Physical Therapist
  • San Juan Capistrano, CA
  • NPI 1598763369
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1972501732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31461 RANCHO VIEJO RD",
            "address_2": "#101",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751864",
            "telephone_number": "949-542-5000",
            "fax_number": "949-419-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31461 RANCHO VIEJO RD",
            "address_2": "#101",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751864",
            "telephone_number": "949-542-5000",
            "fax_number": "949-419-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Gillon
• Libby J Gilman-Fleming, LCSW
• Monica Girgis
• Gordon Arthur Glasgow, M.D.
• Gleason Physical Therapy Inc.
• GMPT
• Angela Goldstein, N.D.
• Emma Alicia Gomez, LCSW
• Jasmine Iliana Gomez
• Michael Gomez, ED.D.

• Physical Therapist in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; 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.