Individual provider Active NPI

Kimberly Kirton Fuselier, PT

  • Physical Therapist
  • Yorba Linda, CA
National Provider Identifier
1063483899
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28620 Issued in CA
Practice address
18200 Yorba Linda Blvd
Suite 308
Yorba Linda, CA 92886-4056
Phone
(714) 646-8070
Fax
(714) 982-5135
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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 PT28620 CA Primary

Addresses

Primary practice location

18200 Yorba Linda Blvd
Suite 308
Yorba Linda, CA 92886-4056

Mailing address

18873 Dry Creek Rd
Yorba Linda, CA 92886-4164
Phone (714) 559-0885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060222000660 CA Practitioner - Physical Therapist in Private Practice 6608882022 Reassigns benefits to 5 organizations
Practice locations: Yorba Linda, CA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Health Medical Group, IncGroup PAC ID 4981646676, 5 clinicians

Practice addresses (Care Compare)

25431 Cabot Rd
Suite 118
Laguna Hills, CA 92653-5527
Phone (949) 362-8877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28620CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mesisca Physical Therapy Inc Physical Therapist CurrentSince Sep 28, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 19, 2022 Accepting new patients
Back2 Health Physical Therapy Inc Physical Therapist CurrentSince Nov 8, 2022 Accepting new patients
Performance Health Medical Group, Inc CurrentSince Jan 6, 2025 Accepting new patients
Lifetime Physical Therapy and Fitness Inc Physical Therapist CurrentSince Jul 5, 2013 Accepting new patients
JM Physical Therapy Inc Physical Therapist Past Accepting new patients
Central Occupational Medicine Providers Ontario Inc Past Accepting new patients

Locations

930 W Alameda Ave
Burbank, CA 91506
Phone (818) 588-3880

12 Mauchly
Ste A
Irvine, CA 92618
Phone (949) 288-4235

25431 Cabot Rd
Ste 118
Laguna Hills, CA 92653
Phone (949) 362-8877

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

Organizations & group practices 7

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": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1063483899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18873 DRY CREEK RD",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864164",
            "telephone_number": "714-559-0885",
            "fax_number": "714-982-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18200 YORBA LINDA BLVD",
            "address_2": "SUITE 308",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928864056",
            "telephone_number": "714-646-8070",
            "fax_number": "714-982-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSELIER",
        "first_name": "KIMBERLY",
        "middle_name": "KIRTON",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT28620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.

Verify at the official NPI Registry.