Individual provider Active NPI

Byeongju Cho, PT

  • Physical Therapist
  • San Bernardino, CA
National Provider Identifier
1023638897
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298356 Issued in CA
Practice address
1181 E Highland Ave Ste B
San Bernardino, CA 92404-4605
Phone
(909) 883-5069
Fax
(909) 883-5473
NPI assigned
Apr 22, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 298356 CA Primary

Addresses

Primary practice location

1181 E Highland Ave Ste B
San Bernardino, CA 92404-4605

Mailing address

PO Box 10016
Redlands, CA 92375-3216
Phone (909) 883-5069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504002737 CA Practitioner - Physical Medicine and Rehabilitation 8527499706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Total Care Physical Therapy IncGroup PAC ID 9830341767, 3 clinicians

Practice addresses (Care Compare)

1181 E Highland Ave
Suite B
San Bernardino, CA 92404-4605
Phone (909) 883-5069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
298356CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Physical Therapy Inc. CurrentSince Apr 15, 2020 Accepting new patients
Northstar Anesthesia of Maryland LLC Past Accepting new patients

Locations

12139 Mount Vernon Ave
Ste 110
Grand Terrace, CA 92313
Phone (909) 370-3396

1181 E Highland Ave
#B
San Bernardino, CA 92404
Phone (909) 883-5069

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1023638897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10016",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923753216",
            "telephone_number": "909-883-5069",
            "fax_number": "909-883-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 E HIGHLAND AVE STE B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924044605",
            "telephone_number": "909-883-5069",
            "fax_number": "909-883-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHO",
        "first_name": "BYEONGJU",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.