Individual provider Active NPI

Lauren Victoria Lederer, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1972858462
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39159 Issued in CA
Practice address
3939 Ruffin Rd
Suite 103
San Diego, CA 92123-1802
Phone
(858) 609-4185
Fax
(858) 609-6651
NPI assigned
Jul 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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 39159 CA Primary

Addresses

Primary practice location

3939 Ruffin Rd
Suite 103
San Diego, CA 92123-1802

Mailing address

3939 Ruffin Rd
Suite 103
San Diego, CA 92123-1802
Phone (858) 609-4185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000631 CA Practitioner - Physical Therapist in Private Practice 5799932356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Southern California Keck School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Es3 Physical Therapy IncGroup PAC ID 2365859550, 5 clinicians
Embody Physical Therapy and Yoga IncGroup PAC ID 6709046584, 2 clinicians

Practice addresses (Care Compare)

10425 Tierrasanta Blvd
Suite 102
San Diego, CA 92124-2618
Phone (858) 598-5055

1330 Orange Ave
Suite 240
Coronado, CA 92118-2951
Phone (619) 261-6049

4452 Park Blvd
Suite 313
San Diego, CA 92116-4049
Phone (619) 261-6049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39159CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Es3 Physical Therapy Inc CurrentSince Sep 6, 2022 Accepting new patients
Embody Physical Therapy & Yoga, Inc. Physical Therapist CurrentSince Nov 20, 2025 Accepting new patients
Select CS Physical Therapy, P.C. Physical Therapist Past Accepting new patients

Locations

4452 Park Blvd
Ste 313
San Diego, CA 92116
Phone (619) 261-6049

10425 Tierrasanta Blvd
Ste 102
San Diego, CA 92124
Phone (858) 598-5055

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": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1972858462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 RUFFIN RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231802",
            "telephone_number": "858-609-4185",
            "fax_number": "858-609-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 RUFFIN RD",
            "address_2": "SUITE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231802",
            "telephone_number": "858-609-4185",
            "fax_number": "858-609-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERER",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39159",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 11, 2012; 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.