Individual provider Active NPI

John David McDonald II, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1083247324
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
298044 Issued in CA
Practice address
8015 S Sepulveda Blvd
Los Angeles, CA 90045-2940
Phone
(310) 991-7751
NPI assigned
Feb 14, 2020
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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 298044 CA Primary

Addresses

Primary practice location

8015 S Sepulveda Blvd
Los Angeles, CA 90045-2940

Mailing address

9714 Regent St Apt 1
Los Angeles, CA 90034-5122
Phone (340) 998-2996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409001676 CA Practitioner - Physical Therapist in Private Practice 7113356395 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optc Westside IncGroup PAC ID 1355394214, 8 clinicians
Stay Ready IncGroup PAC ID 5395840466, 8 clinicians

Practice addresses (Care Compare)

10190 Culver Blvd
Culver City, CA 90232-3152
Phone (310) 837-9700

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

LicenseStateTypeSpecialty
298044CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wavefit Physical Therapy, Inc Physical Therapist CurrentSince Feb 27, 2020 Accepting new patients
Stay Ready Inc Physical Therapist CurrentSince Oct 7, 2020 Accepting new patients
Body Rehab Center Physical Therapist PastSince Oct 7, 2020 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

2610 Artesia Blvd
Redondo Beach, CA 90278
Phone (310) 991-7751

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1083247324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9714 REGENT ST APT 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900345122",
            "telephone_number": "340-998-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900452940",
            "telephone_number": "310-991-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-14",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "298044",
            "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 Feb 14, 2020; 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.