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ADVANCED SPORTS MEDICINE & ORTHOPEDIC PT
NPI 1558406728
Physical Therapist - Orthopedic in Manhattan Beach, CA

Active since February 21, 2007
1200 ROSECRANS AVE STE 206, MANHATTAN BEACH, CA 90266(310) 416-9700(310) 416-1120 Get Directions Write a Review

NPPES record last updated: May 29, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 29, 2020, Apr 22, 2020 (2 updates tracked since 2020).

About Advanced Sports Medicine & Orthopedic Pt NPPES

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

ADVANCED SPORTS MEDICINE & ORTHOPEDIC PT (NPI 1558406728) is a healthcare organization registered as an orthopedic in Manhattan Beach, California and active in the NPI registry since February 2007. The organization lists Dana Molina, Administrator, as its authorized official.

NPPES Registry Identity

NPI1558406728
Entity TypeOrganization
Primary Taxonomy2251X0800X
Legal Business NameADVANCED SPORTS MEDICINE & ORTHOPEDIC PT
Location Address1200 ROSECRANS AVE STE 206Manhattan Beach, CA 90266-2451
Mailing Address1200 Rosecrans Ave Ste 206Manhattan Beach, CA 90266-2451 · (310) 416-9700 · Fax (310) 416-1120
Phone(310) 416-9700
Fax(310) 416-1120
Organization SubpartNo
Authorized OfficialDana MolinaAdministrator · (310) 416-9793
Enumeration DateFebruary 21, 2007
Last NPPES UpdateMay 29, 20202 updates tracked since enumeration
NPPES CertifiedMay 29, 2020
✔ NPI 1558406728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in CA · PT18890
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
1200 ROSECRANS AVE STE 206, Manhattan Beach, CA 90266
Open in Google Maps ↗

Other Identifiers 1

OtherPT18890CA · License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Sports Medicine & Orthopedic Pt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20050114000902Non-DME Part B · Clinic/Group PracticeDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Advanced Sports Medicine & Orthopedic Pt, which bills Medicare for the services this clinician delivers.

Clinician (1)

Timothy Mccauley, MSPT
Physical Therapist in Private Practice
NPI 1518131267
1200 ROSECRANS AVE STE 206
Manhattan Beach, CA 90266
(310) 416-9700
✔ Accepts MedicareSame address

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

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 Advanced Sports Medicine & Orthopedic Pt's NPI number?

The NPI number for Advanced Sports Medicine & Orthopedic Pt is 1558406728. It was assigned to this organization in the NPPES registry on February 21, 2007.

Where is Advanced Sports Medicine & Orthopedic Pt located?

Advanced Sports Medicine & Orthopedic Pt is located at 1200 Rosecrans Ave Ste 206, Manhattan Beach, CA 90266. The listed phone number is (310) 416-9700.

What is Advanced Sports Medicine & Orthopedic Pt's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Advanced Sports Medicine & Orthopedic Pt enrolled in Medicare?

Yes. Advanced Sports Medicine & Orthopedic Pt is registered in the Medicare PECOS enrollment system.

When is Advanced Sports Medicine & Orthopedic Pt's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Advanced Sports Medicine & Orthopedic Pt?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Advanced Sports Medicine & Orthopedic Pt. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Advanced Sports Medicine & Orthopedic Pt was last updated on May 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.