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PROSPORT PHYSICAL THERAPY PROFESSIONALS INC
NPI 1649223694
Specialist in Costa Mesa, CA

Active since May 19, 2006
2777 BRISTOL ST, STE B, COSTA MESA, CA 92626(949) 250-1112(949) 250-1401 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 6, 2023, Dec 13, 2021, Jan 9, 2017 (3 updates tracked since 2017).

About Prosport Physical Therapy Professionals Inc NPPES

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

PROSPORT PHYSICAL THERAPY PROFESSIONALS INC (NPI 1649223694), doing business as Prosport Physical Therapy Inc, is a healthcare organization registered as a specialist in Costa Mesa, California and active in the NPI registry since May 2006. The organization lists Bobby Ismail, President, as its authorized official.

NPPES Registry Identity

NPI1649223694
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePROSPORT PHYSICAL THERAPY PROFESSIONALS INC
Location Address2777 BRISTOL ST, STE BCosta Mesa, CA 92626-5997
Mailing AddressPo Box 14155Orange, CA 92863-1555 · (714) 450-4999 · Fax (714) 974-0055
Phone(949) 250-1112
Fax(949) 250-1401
Organization SubpartNo
Authorized OfficialBobby IsmailPresident · (209) 353-1988
Enumeration DateMay 19, 2006
Last NPPES UpdateDecember 6, 20233 updates tracked since enumeration
NPPES CertifiedDecember 6, 2023
✔ NPI 1649223694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2777 BRISTOL ST, Costa Mesa, CA 92626
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Other Names 1

Former Legal Business NameProsport Physical Therapy Inc

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prosport Physical Therapy Professionals Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

111

Medicare enrollment records show 111 clinicians reassign Medicare billing to Prosport Physical Therapy Professionals Inc, which bills Medicare for the services they deliver. Of these, 19 practice at this address and 45 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Physical Therapist in Private Practice110
Physical Medicine and Rehabilitation1

Nearest to this location (20)

See all 111
Samantha Baumler, DPT
Physical Therapist in Private Practice
NPI 1912203381
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Andrea Bellitti, DPT
Physical Therapist in Private Practice
NPI 1508814542
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Sydney Cabellon, DPT
Physical Therapist in Private Practice
NPI 1689372781
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Stacey Castaldo, DPT
Physical Therapist in Private Practice
NPI 1659053783
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Kevin Castillo, PT
Physical Therapist in Private Practice
NPI 1043827173
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1122
✔ Accepts MedicareSame address
Cameron Craver, PT, DPT
Physical Therapist in Private Practice
NPI 1174201099
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Joseph Donohue, PT
Physical Therapist in Private Practice
NPI 1619930252
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
Same address
Christopher Espino, DPT
Physical Therapist in Private Practice
NPI 1114617891
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Ashley Henkes, PT, DPT
Physical Therapist in Private Practice
NPI 1659018307
2777 BRISTOL ST
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Victor Nguyen, D.P.T.
Physical Therapist in Private Practice
NPI 1790296192
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Ethan Osborne, DPT, PT
Physical Therapist in Private Practice
NPI 1376240911
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Alexandra Rolda, PT
Physical Therapist in Private Practice
NPI 1801593850
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Ray Roman, DPT
Physical Therapist in Private Practice
NPI 1831227156
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Samantha Sawicki, DPT, PT
Physical Therapist in Private Practice
NPI 1710458880
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Kevin Tran, PT, DPT
Physical Therapist in Private Practice
NPI 1568175461
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Mohamadreza Moghadam
Physical Therapist in Private Practice
NPI 1972463495
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Brandon Tsai
Physical Therapist in Private Practice
NPI 1083549703
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Jacob Halmrast, DPT
Physical Therapist in Private Practice
NPI 1609607142
2777 BRISTOL ST
Costa Mesa, CA 92626
(949) 250-1112
✔ Accepts MedicareSame address
Megan Wiechmann, PT
Physical Therapist in Private Practice
NPI 1811628050
2777 BRISTOL ST STE B
Costa Mesa, CA 92626
(949) 250-1112
Same address
Louis Taylor, MPT
Physical Therapist in Private Practice
NPI 1588612840
2651 IRVINE AVE SUITE 128
Costa Mesa, CA 92627
(949) 722-8811
✔ Accepts Medicare1.1 mi
See all 111 clinicians

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 Prosport Physical Therapy Professionals Inc's NPI number?

The NPI number for Prosport Physical Therapy Professionals Inc is 1649223694. It was assigned to this organization in the NPPES registry on May 19, 2006. The provider was formerly known as Prosport Physical Therapy Inc.

Where is Prosport Physical Therapy Professionals Inc located?

Prosport Physical Therapy Professionals Inc is located at 2777 Bristol St Ste B, Costa Mesa, CA 92626. The listed phone number is (949) 250-1112.

What is Prosport Physical Therapy Professionals Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Prosport Physical Therapy Professionals Inc enrolled in Medicare?

Yes. Prosport Physical Therapy Professionals Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Prosport Physical Therapy Professionals Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 111 clinicians in 2 Medicare specialties reassign their Medicare billing to Prosport Physical Therapy Professionals Inc. 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. The largest specialties are Physical Therapist in Private Practice (110) and Physical Medicine and Rehabilitation (1). Of these, 19 practice at this address and 45 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Prosport Physical Therapy Professionals Inc was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.