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ELYSE HARUKO MINAMIDE PT, DPT, NCS
NPI 1629587233
Physical Therapist - Neurology in Tustin, CA

Active since September 26, 2017
14851 YORBA ST, TUSTIN, CA 92780(714) 832-9200 Get Directions Write a Review

NPPES record last updated: September 26, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Elyse Haruko Minamide Pt, Dpt, Ncs NPPES

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

ELYSE HARUKO MINAMIDE PT, DPT, NCS (NPI 1629587233) is an individual neurology provider in Tustin, California, licensed in California (37628) and active in the NPI registry since September 2017. She is a graduate of Other (2010).

NPPES Registry Identity

NPI1629587233
Entity TypeIndividualFemale
Primary Taxonomy2251N0400X
Provider Legal NameELYSE HARUKO MINAMIDECredential: PT, DPT, NCS
Location Address14851 YORBA STTustin, CA 92780-2925
Mailing Address38 MilagroRancho Santa Margarita, CA 92688-2882
Phone(714) 832-9200
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateSeptember 26, 2017
✔ NPI 1629587233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · NeurologyRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251N0400X
License✔ Licensed in CA · 37628
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Neurologic Physical Therapy, who has demonstrated specialized knowledge and skill in neuroanatomy and neurophysiology, including knowledge of central, peripheral, and autonomic nervous systems in populations with and without neurologic conditions; motor control and movement sciences in populations with and without neurologic conditions; behavioral sciences, including psychology and neuropsychology, and psychiatry; and medical management and pharmacology.
14851 YORBA ST, Tustin, CA 92780
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Other Names 1

Former Name (1)Elyse Haruko Minamide

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elyse Haruko Minamide Pt, Dpt, Ncs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840759874
PECOS Enrollment IDI20260828003393

Medicare Billing Reassignment

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

California Luna Care Physical Therapy PC
335 mi
Physical Therapist
16185 LOS GATOS BLVD STE 205
Los Gatos, CA 95032
  • Reassigned Medicare billing, California enrollment
  • 1,388 clinicians in this Medicare group
NPI 1689162166 (866) 525-3175

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 3

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

GRACE LAM M.A., CCC-SLP
Speech-Language Pathologist
14851 YORBA ST
TUSTIN, CA 92780
Orange County (714) 573-5382
GHC OF TUSTIN LLC
Skilled Nursing Facility
14851 YORBA ST
TUSTIN, CA 92780
Orange County (657) 467-4341
MISS HOAIHUONG TRAN NGO LCSW
Social Worker (Clinical)
14851 YORBA ST
TUSTIN, CA 92780
Orange County (714) 573-5341

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 Elyse Minamide's NPI number?

The NPI number for Elyse Minamide is 1629587233. It was assigned to this individual provider in the NPPES registry on September 26, 2017. The provider is also known as Elyse Haruko Minamide.

Where is Elyse Minamide located?

Elyse Minamide practices at 14851 Yorba St, Tustin, CA 92780. The listed phone number is (714) 832-9200.

What is Elyse Minamide's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Neurology, with taxonomy code 2251N0400X.

Is Elyse Minamide enrolled in Medicare?

Yes. Elyse Minamide is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Elyse Minamide's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elyse Minamide reassigns Medicare benefits to California Luna Care Physical Therapy PC (Los Gatos, 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 Elyse Minamide'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 Elyse Minamide was last updated on September 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.