Ismansjah Soekardi, PT | |
6193 Soquel Drive, Aptos, CA 95003 | |
(831) 462-1212 | |
(831) 462-1221 |
Full Name | Ismansjah Soekardi |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 25 Years |
Location | 6193 Soquel Drive, Aptos, California |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215054721 | NPI | - | NPPES |
PT25843 | Other | CA | CA PT LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT25843 (California) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
California Orthopedic And Sports Therapy Rehabilitation Services, Inc. | 6709940455 | 2 |
High Desert Therapists, Inc | 9436145166 | 6 |
Provider Name | California Orthopedic & Sports Therapy Rehabilitation Services, Inc. |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1417164328 PECOS PAC ID: 6709940455 Enrollment ID: O20090126000377 |
Provider Name | High Desert Therapists, Inc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1467402016 PECOS PAC ID: 9436145166 Enrollment ID: O20100326000288 |
Mailing Address | Practice Location Address |
---|---|
Ismansjah Soekardi, PT 953 Columbus Dr, Capitola, CA 95010-2309 Ph: (831) 688-1212 | Ismansjah Soekardi, PT 6193 Soquel Drive, Aptos, CA 95003 Ph: (831) 462-1212 |
Mohan Micheal Siegel, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 134 Hyannis Ct, Aptos, CA 95003 Phone: 831-600-6214 | |
Sanna Physical Therapy Inc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7539 Soquel Drive, Aptos, CA 95003 Phone: 831-688-1332 | |
Mrs. Kimberly Ann Barry, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2505c Cabrillo College Dr., Aptos, CA 95003 Phone: 831-464-3901 Fax: 831-464-3010 | |
Dr. Daniel Edward Campbell, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2505 Cabrillo College Dr, Aptos, CA 95003 Phone: 831-464-3901 | |
Mr. Kevin Eugene Howard, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7575 Soquel Dr, Aptos, CA 95003 Phone: 831-688-5156 | |
Hina Shaikh, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7887 Soquel Dr, Aptos, CA 95003 Phone: 831-662-4547 |