Active NPI
Jan-Bernard Manalang Aquino, PT, DPT
- Physical Therapist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 301206
- Practice address
- 5478 Wilshire Blvd Ste 208
Los Angeles, CA 90036-4225 - Phone
- (323) 936-7525
- NPI assigned
- Nov 10, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 301206 | CA | Primary |
Addresses
Primary practice location
5478 Wilshire Blvd Ste 208
Los Angeles, CA 90036-4225
Mailing address
16121 Blackhawk St
Granada Hills, CA 91344-7007
Phone (818) 427-6172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175
5478 Wilshire Blvd
Suite 208
Los Angeles, CA 90036-4225
Phone (323) 936-7525
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301206 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stay Ready Inc | Physical Therapist | Current | Accepting new patients |
| California Luna Care Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
| Body Rehab Center | Physical Therapist | Past | Accepting new patients |
Locations
17323 Ventura Blvd
Ste 100
Encino, CA 91316
Phone (323) 936-7525
5478 Wilshire Blvd
Ste 208
Los Angeles, CA 90036
Phone (323) 936-7525
16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108
Organizations & group practices 3
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.
-
- Physical Therapist
- Los Gatos, CA
- NPI 1689162166
-
- Physical Therapist
- Los Angeles, CA
- NPI 1497859177
-
- Physical Therapist
- Los Angeles, CA
- NPI 1215153747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1053077354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16121 BLACKHAWK ST",
"city": "GRANADA HILLS",
"state": "CA",
"postal_code": "913447007",
"telephone_number": "818-427-6172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5478 WILSHIRE BLVD STE 208",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900364225",
"telephone_number": "323-936-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "JAN-BERNARD",
"middle_name": "MANALANG",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "301206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.