Performance Care Sports Medicine & Rehabilitation Center, Inc. is a medicare enrolled "Internal Medicine" provider in Toluca Lake, California. Their current practice location is
10738 Riverside Drive, Suite A, Toluca Lake, California. You can reach out to their office (for appointments etc.) via phone at
(818) 766-4307.
Performance Care Sports Medicine & Rehabilitation Center, Inc. is licensed to practice in California (license number A42627) and it also participates in the medicare program. Performance Care Sports Medicine & Rehabilitation Center, Inc.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1487880399.
Healthcare Provider's Profile
| Full Name | Performance Care Sports Medicine & Rehabilitation Center, Inc. |
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| Type | Facility |
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| Speciality | Internal Medicine |
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| Location | 10738 Riverside Drive, Suite A, Toluca Lake, California |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1487880399
- Provider Enumeration Date: 06/05/2009
- Last Update Date: 11/20/2014
Medicare PECOS Information:
- PECOS PAC ID: 6406179274
- Enrollment ID: O20141231000921
Medical Identifiers
Medical identifiers for Performance Care Sports Medicine & Rehabilitation Center, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487880399 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | DC25362 (California) | Secondary |
| 207R00000X | Internal Medicine | A42627 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Performance Care Sports Medicine & Rehabilitation Center, Inc. acts as a billing entity for following providers:
| Provider Name | Golan Nissim |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1932270147
PECOS PAC ID: 2365402906
Enrollment ID: I20041019000624 |
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| Provider Name | Jeko Behfarin |
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| Provider Type | Practitioner - General Practice |
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| Provider Identifiers | NPI Number: 1689686875
PECOS PAC ID: 0941217228
Enrollment ID: I20060310000435 |
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| Provider Name | Zachary Ray |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1174853162
PECOS PAC ID: 3072658541
Enrollment ID: I20100309000090 |
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| Provider Name | Laura K Wilson |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1558537977
PECOS PAC ID: 1951324987
Enrollment ID: I20200504000879 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Performance Care Sports Medicine & Rehabilitation Center, Inc. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Performance Care Sports Medicine & Rehabilitation Center, Inc.
10738 Riverside Dr Ste A,
Toluca Lake, CA 91602-2372
Ph: (818) 766-4307 | Performance Care Sports Medicine & Rehabilitation Center, Inc.
10738 Riverside Drive, Suite A,
Toluca Lake, CA 91602-2372
Ph: (818) 766-4307 |
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