Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roshan Kottayadiyil Varghese

Individual provider Physical Therapist · NPI 1912604083

Roshan Kottayadiyil Varghese is a Physical Therapist in Private Practice in Lake Elsinore, California. Qualified in 2022, 4 years ago. Practices with Mdrs Spine and Sport Inc, a 182-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2023

Practice location Address checks out

425 Diamond Dr Ste 101
Lake Elsinore, CA 92530-4495
Phone: (951) 674-9517
Fax: (951) 674-9517
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 303260 (CA)

Record details

NPI number1912604083
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 9, 2023
Last updated in NPPESNovember 13, 2023
Certification dateNovember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mdrs Spine And Sport Inc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Lake Elsinore