NPIMap

Organization Active NPI

Praxis Physical Therapy, Inc.

  • Physical Therapist
  • San Pedro, CA
National Provider Identifier
1003960949
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12729 Issued in CA
Legal business name
PRAXIS PHYSICAL THERAPY, INC.
Practice address
1360 W 6TH St
#210 North Building
San Pedro, CA 90732-3514
Phone
(310) 548-3130
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kathryn Kassai, PTNPI 1881788354
Title
Owner
Phone
(310) 548-3130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT12729 CA Primary

Addresses

Primary practice location

1360 W 6TH St
#210 North Building
San Pedro, CA 90732-3514

Mailing address

1360 W 6TH St
#210 North Building
San Pedro, CA 90732-3514
Phone (310) 548-3130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101207000739 CA Part B Supplier - Clinic/Group Practice 7315134095 Receives reassigned benefits from 8 practitioners
Practice locations: San Pedro, CA

National Provider Directory

National Provider Directory

Locations

1360 W 6th St
Ste 210
San Pedro, CA 90732
Phone (310) 548-3130

1360 W 6th St
Ste 210N
San Pedro, CA 90732
Phone (310) 548-3130

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003960949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "#210 NORTH BUILDING",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-548-3130",
            "fax_number": "310-548-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "address_2": "#210 NORTH BUILDING",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-548-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAXIS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASSAI",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-548-3130",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.