SEYED EHSAN HAERI – Physical Therapist, NPI 1144093428

SEYED EHSAN HAERI is a healthcare provider. based in Camarillo, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 304984 (CA). The NPI Number for SEYED EHSAN HAERI is 1144093428

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
SEYED EHSAN HAERI
NPI
1144093428
Phone
(805) 804-4168
Address
1203 FLYNN RD UNIT 160
Enumeration Date
30 October 2023
Last Update Date
20 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8053794574
Graduation Year
2013 (13 years ago)
PAC ID
2860843109
Group Practice PAC ID
2062312911
Professional Enrollment ID
I20240110004672
Address ID
CA913605707TH137XXBLVD500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

9,448 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for SEYED EHSAN HAERI

  • 1203 FLYNN RD UNIT 160

    CAMARILLO, CA 930126203

    Phone: (805) 804-4168

    Fax: (805) 830-1177

    Type: Mailing

  • 1855 COCHRAN ST STE 109

    SIMI VALLEY, CA 930652265

    Phone: (805) 526-2311

    Fax: (805) 526-6608

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240110004672IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93012)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062312911View full group profile
NameSpecialtyState
-CA
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
-CA
Physical Therapist In Private PracticeCA
-CA
Sports Medicine, Orthopedic SurgeryCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Hand Surgery, Orthopedic SurgeryCA

Reviews

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Frequently asked questions

How is SEYED EHSAN HAERI identified in CMS data?
CMS-hosted NPPES data lists SEYED EHSAN HAERI with NPI 1144093428.
Is SEYED EHSAN HAERI listed as active for patients and plans?
The listing shows SEYED EHSAN HAERI as active in the NPI system.
What is SEYED EHSAN HAERI's specialty?
The listing groups SEYED EHSAN HAERI with Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for SEYED EHSAN HAERI?
SEYED EHSAN HAERI's geographic hint is Camarillo, California in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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