Ennis Khaleq, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

303179 Issued in CA

Practice address

64870 La Costa CT
Desert Hot Springs, CA 92240-1415

Phone

(714) 605-3698

Fax

(866) 225-9947

NPI assigned

Jan 23, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

On the Move RehabGroup PAC ID 6709195316, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• On the Move Rehab

  • Physical Therapist
  • Cathedral City, CA
  • NPI 1356710925
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1073325437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69472 SERENITY RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922347921",
            "telephone_number": "760-409-6383",
            "fax_number": "866-225-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64870 LA COSTA CT",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922401415",
            "telephone_number": "714-605-3698",
            "fax_number": "866-225-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEQ",
        "first_name": "ENNIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Steven Kalkoske, PPS
• Matthew Gaire Keane, PHYSICIAN ASSISTANT
• Sarah Kee, RN
• Abbeygail Kemp
• Keyur Shodhan DDS Inc (Shodhan Dentistry)
• Chu Yung Kim
• Ena Kim, MD
• Soo Jin Kim, PHARM.D
• Kathleen King, PHD, NCSP
• Shenoah J Klein

• Physical Therapist in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.