Individual provider Active NPI

Kyle Jordan Olandt, DPT

  • Physical Therapist
  • San Juan Capistrano, CA
National Provider Identifier
1073158440
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297691 Issued in CA
Practice address
32261 Camino Capistrano
San Juan Capistrano, CA 92675-3746
Phone
(818) 421-4745
NPI assigned
Nov 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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 297691 CA Primary

Addresses

Primary practice location

32261 Camino Capistrano
San Juan Capistrano, CA 92675-3746

Mailing address

32261 Camino Capistrano
Ste D101
San Juan Capistrano, CA 92675-3747
Phone (818) 421-4745

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200212000039 CA Practitioner - Physical Therapist in Private Practice 0840626859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy of Newport, Inc. Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Ignite Phyzio & Sports Performance Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

2925 Airway Ave
Ste A
Costa Mesa, CA 92626
Phone (714) 335-3182

811 E Lambert Rd
La Habra, CA 90631
Phone (562) 896-0129

747 Dover Dr
Newport Beach, CA 92663
Phone (714) 335-3182

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": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1073158440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32261 CAMINO CAPISTRANO",
            "address_2": "STE D101",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753747",
            "telephone_number": "818-421-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32261 CAMINO CAPISTRANO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753746",
            "telephone_number": "818-421-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLANDT",
        "first_name": "KYLE",
        "middle_name": "JORDAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.