Active NPI
Koby Markko Jansen, PT, DPT
- Physical Therapist
- Chandler, AZ
National Provider Identifier
1073377685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 375 E Elliot Rd
Chandler, AZ 85225-1129 - Phone
- (480) 912-6400
- NPI assigned
- Feb 13, 2024
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
375 E Elliot Rd
Chandler, AZ 85225-1129
Mailing address
22764 E Lords Way
Queen Creek, AZ 85142-0705
Phone (956) 609-1197
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250331000505 | AZ | Practitioner - Physical Therapist in Private Practice | 1557703204 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Move Human Performance and Physical Therapy
Practice addresses (Care Compare)
375 E Elliot Rd
Suite 7
Chandler, AZ 85225-1122
Phone (480) 912-6400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 052185 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Move Human Performance and Physical Therapy | Current | Accepting new patients |
Locations
375 E Elliot Rd
Ste 7
Chandler, AZ 85225
Phone (480) 516-5815
Organizations & group practices 1
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 Therapy Clinic/Center
- Chandler, AZ
- NPI 1215490701
AZ
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753056000000",
"number": "1073377685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22764 E LORDS WAY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851420705",
"telephone_number": "956-609-1197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 E ELLIOT RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852251129",
"telephone_number": "480-912-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "KOBY",
"middle_name": "MARKKO",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-13",
"last_updated": "2025-07-21",
"certification_date": "2025-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.