Active NPI
Susan Awdishu, PT
- Orthopedic Physical Therapist
- Tarzana, CA
National Provider Identifier
1992221360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 291953
- Practice address
- 18344 Oxnard St Ste 104
Tarzana, CA 91356-6760 - Phone
- (818) 783-4085
- NPI assigned
- Aug 17, 2017
- Last updated
- Aug 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 291953 | CA | Primary |
Addresses
Primary practice location
18344 Oxnard St Ste 104
Tarzana, CA 91356-6760
Mailing address
8800 Etiwanda Ave Apt 6
Northridge, CA 91325-0901
Phone (818) 813-1757
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
| License | State | Type | Specialty |
|---|---|---|---|
| 291953 | CA | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Physical Therapy Inc. | Current | Accepting new patients | |
| Body Dynamix Integrated Sports Medicine, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Northridge, CA
- NPI 1730076423
-
- Physical Medicine & Rehabilitation Physician
- Tarzana, CA
- NPI 1912386376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502928000000",
"number": "1992221360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8800 ETIWANDA AVE APT 6",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913250901",
"telephone_number": "818-813-1757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18344 OXNARD ST STE 104",
"city": "TARZANA",
"state": "CA",
"postal_code": "913566760",
"telephone_number": "818-783-4085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AWDISHU",
"first_name": "SUSAN",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2017-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "291953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarzana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.