Individual provider Active NPI

Michael Ratajac, PT, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1992482434
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT304105 Issued in CA
Practice address
3760 Convoy St Ste 100
San Diego, CA 92111-3743
Phone
(858) 573-9368
NPI assigned
Jun 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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 PT304105 CA Primary

Addresses

Primary practice location

3760 Convoy St Ste 100
San Diego, CA 92111-3743

Mailing address

5182 Biltmore St
San Diego, CA 92117-1106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718002282 CA Practitioner - Physical Therapist in Private Practice 3274993530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

1020 Tierra del Rey
Suite a 1
Chula Vista, CA 91910-7886
Phone (619) 585-7104

450 Rosewood Ave
Suite 105
Camarillo, CA 93010-5914
Phone (805) 389-4781

5807 University Ave
Suite 6
San Diego, CA 92115-6295
Phone (619) 500-0109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT304105CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
MDRS Spine & Sport, Inc Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients

Locations

450 Rosewood Ave
Ste 105
Camarillo, CA 93010
Phone (805) 389-4781

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

14150 Culver Dr
Ste 103
Irvine, CA 92604
Phone (949) 262-9142

9852 Business Park Dr
Ste A
Sacramento, CA 95827
Phone (916) 362-7962

3760 Convoy St
Ste 100
San Diego, CA 92111
Phone (858) 264-1434

5807 University Ave
Ste 6
San Diego, CA 92115
Phone (619) 500-0109

3707 Convoy St
Ste 100
San Diego, CA 92111
Phone (858) 573-9368

1801 Cleveland Ave
Ste B
Santa Rosa, CA 95401
Phone (707) 526-4180

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": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1992482434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5182 BILTMORE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 CONVOY ST STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113743",
            "telephone_number": "858-573-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATAJAC",
        "first_name": "MICHAEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT304105",
            "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 Jun 28, 2023; 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.