Individual provider Active NPI

Alexandra Joanne Cushman, P.T., D.P.T.

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1992251896
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292178 Issued in CA
Practice address
1922 Hacienda Dr
Vista, CA 92081
Phone
(760) 295-4175
Fax
(760) 295-4176
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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 292178 CA Primary

Addresses

Primary practice location

1922 Hacienda Dr
Vista, CA 92081

Mailing address

1045 N Vulcan Ave Apt D
Encinitas, CA 92024-1793
Phone (804) 938-0331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127003050 CO Practitioner - Physical Therapist in Private Practice 5294014056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Virginia Commonwealth University, School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Action Physical TherapyGroup PAC ID 8426040643, 5 clinicians

Practice addresses (Care Compare)

150 Old Laramie TRL
Unit 100
Lafayette, CO 80026-7019
Phone (303) 685-8747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Action Physical Therapy Physical Therapist CurrentSince Sep 20, 2023 Accepting new patients
Rancho Physical Therapy, Inc. Physical Therapist PastSince Oct 7, 2016 Accepting new patients

Locations

150 Old Laramie Trl
Unit 100
Lafayette, CO 80026
Phone (303) 665-8747

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1992251896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 N VULCAN AVE APT D",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241793",
            "telephone_number": "804-938-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 HACIENDA DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "92081",
            "telephone_number": "760-295-4175",
            "fax_number": "760-295-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "ALEXANDRA",
        "middle_name": "JOANNE",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.