Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. TIM G URSICH DC
NPI 1053590794
Chiropractor - Sports Physician in Rancho Palos Verdes, CA

Q: What is Tim Ursich's NPI number?

The NPI number for Tim Ursich is 1053590794. It was assigned to this individual provider in the NPPES registry on October 30, 2007.

Q: What is Tim Ursich's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Q: When was this NPI record last updated?

The NPPES record for Tim Ursich was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 30, 2007

28633 S WESTERN AVE STE 200, RANCHO PALOS VERDES, CA 90275(310) 832-2622(310) 832-2621 Get Directions Write a Review

NPPES record last updated: September 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 29, 2026, Jan 27, 2026, Dec 9, 2020 and 1 more (4 updates tracked since 2018).

On this page

About Mr. Tim G Ursich Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TIM G URSICH DC (NPI 1053590794) is an individual sports physician in Rancho Palos Verdes, California, licensed in California (DC12564) and active in the NPI registry since October 2007. He maintains a secondary practice location in Rancho Palos Verdes.

NPPES Registry Identity

NPI1053590794

Entity TypeIndividualMale

Primary Taxonomy111NS0005X

Provider Legal NameMR. TIM G URSICHCredential: DC

Location Address28633 S WESTERN AVE STE 200Rancho Palos Verdes, CA 90275-0817

Mailing Address28633 S Western Ave Ste 200Rancho Palos Verdes, CA 90275-0817 · (310) 832-2622 · Fax (310) 832-2621

Phone(310) 832-2622

Fax(310) 832-2621

Sole ProprietorNo

Enumeration DateOctober 30, 2007

Last NPPES UpdateSeptember 29, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2026

✔ NPI 1053590794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers

Taxonomy Code111NS0005X

License✔ Licensed in CA · DC12564

Definition

A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.

28633 S WESTERN AVE STE 200, Rancho Palos Verdes, CA 90275

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Secondary Practice Location 1

Location 129000 S Western Ave Ste 100Rancho Palos Verdes, CA 90275-0826 · Phone (310) 832-2622 · Fax (310) 832-2621

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Tim G Ursich Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Tim Ursich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Tim G Ursich Chiropractic Inc

Same address

Sports Physician

28633 S WESTERN AVE, SUITE 200
Rancho Palos Verdes, CA 90275

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Tim G Ursich Chiropratic Inc
4 clinicians in this Medicare group

NPI 1609922038 (310) 832-2622

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARINA SPORTS REHAB PC

Physical Therapist

28633 S WESTERN AVE STE 200
RANCHO PALOS VERDES, CA 90275

Los Angeles County (310) 832-2622

DR. TIMOTHY JOSHUA URSICH DC

Chiropractor

28633 S WESTERN AVE STE 200
RANCHO PALOS VERDES, CA 90275

Los Angeles County (310) 832-2622

SOUTH BAY PREMIER MRI LLC

Clinic/Center (Magnetic Resonance Imaging (MRI))

28633 S WESTERN AVE STE 200
RANCHO PALOS VERDES, CA 90275

Los Angeles County (310) 339-9620

JEAN CIGLIANO PT

Physical Therapist

28633 S WESTERN AVE STE 200
RANCHO PALOS VERDES, CA 90275

Los Angeles County (310) 832-2622

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tim Ursich's NPI number?

The NPI number for Tim Ursich is 1053590794. It was assigned to this individual provider in the NPPES registry on October 30, 2007.

Where is Tim Ursich located?

Tim Ursich practices at 28633 S Western Ave Ste 200, Rancho Palos Verdes, CA 90275. The listed phone number is (310) 832-2622.

What is Tim Ursich's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Tim Ursich enrolled in Medicare?

Yes. Tim Ursich is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tim Ursich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tim Ursich reassigns Medicare benefits to Tim G Ursich Chiropractic Inc (Rancho Palos Verdes, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tim Ursich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tim Ursich was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.