Individual provider Active NPI

Ailene Andal Juarez, MPT, DPT

  • Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1982934253
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29723 Issued in CA
Practice address
4341 Birch St
Suite 102
Newport Beach, CA 92660-1924
Phone
(949) 475-1002
Fax
(949) 475-1003
NPI assigned
Jan 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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 29723 CA Primary

Addresses

Primary practice location

4341 Birch St
Suite 102
Newport Beach, CA 92660-1924

Mailing address

4341 Birch St
Suite 102
Newport Beach, CA 92660-1924
Phone (949) 475-1002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29723CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Consulting Group Physical Therapist Past Accepting new patients

Organizations & group practices 1

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": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1982934253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 BIRCH ST",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601924",
            "telephone_number": "949-475-1002",
            "fax_number": "949-475-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 BIRCH ST",
            "address_2": "SUITE 102",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601924",
            "telephone_number": "949-475-1002",
            "fax_number": "949-475-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "AILENE",
        "middle_name": "ANDAL",
        "credential": "MPT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.