Individual provider Active NPI

Ana Luisa Elizondo, MSPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1972776920
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21304 Issued in CA
Practice address
4010 Sorrento Valley Blvd
Suite 300
San Diego, CA 92121-1432
Phone
(858) 793-7860
Fax
(858) 436-1289
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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 PT 21304 CA Primary

Addresses

Primary practice location

4010 Sorrento Valley Blvd
Suite 300
San Diego, CA 92121-1432

Mailing address

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120-5238
Phone (619) 229-3909

Other identifiers 1

IdentifierTypeStateIssuer
CB219438OtherCAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140910001803 CA Practitioner - Physical Therapist in Private Practice 8022237890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SD Sports Medicine and Family Health CenterGroup PAC ID 7113812496, 38 clinicians

Practice addresses (Care Compare)

6699 Alvarado Rd
Suite 2100
San Diego, CA 92120-5238
Phone (619) 229-3909

Merit-based Incentive Payment System (MIPS)

Final score
90.4 of 100Reported as group
Quality
93.75
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 21304CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SD Sports Medicine and Family Health Center CurrentSince May 27, 2016 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

10505 Sorrento Valley Rd
Ste 200
San Diego, CA 92121
Phone (858) 793-7860

6699 Alvarado Rd
Ste 2100
San Diego, CA 92120
Phone (619) 229-3909

4010 Morena Blvd
Ste 210
San Diego, CA 92117
Phone (858) 224-7970

4010 Sorrento Valley Blvd
Ste 300
San Diego, CA 92121
Phone (858) 678-0300

Organizations & group practices 3

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1972776920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "STE 2100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205238",
            "telephone_number": "619-229-3909",
            "fax_number": "619-229-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 SORRENTO VALLEY BLVD",
            "address_2": "SUITE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211432",
            "telephone_number": "858-793-7860",
            "fax_number": "858-436-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "ANA",
        "middle_name": "LUISA",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 21304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB219438",
            "state": "CA"
        }
    ],
    "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 Oct 31, 2016; 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.