Michael John Koury, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT12179 Issued in CA

Practice address

20211 Patio Drive
Ste 205
Castro Valley, CA 94546

Phone

(510) 537-3991

Fax

(510) 537-7997

NPI assigned

Nov 30, 2005

Last updated

Apr 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• California Sports Physical Therapy Centers, Inc.

  dba California Sports Physical Therapy

  • Physical Therapist
  • Monterey, CA
  • NPI 1467436329
  Medicare reassignment NPD
• California Sports Physical Therapy Centers Inc

  dba Albany Physical Therapy

  • Physical Therapist
  • Albany, CA
  • NPI 1891472965
  NPD

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1093799496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20211 PATIO DR",
            "address_2": "#205",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464338",
            "telephone_number": "510-537-3991",
            "fax_number": "510-537-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20211 PATIO DRIVE",
            "address_2": "STE 205",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "94546",
            "telephone_number": "510-537-3991",
            "fax_number": "510-537-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURY",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT12179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "ZZZ16603Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Rose Klippenes, LMFT
• Donald Richard Knotts, MEDICAL DOCTOR
• Wei-Fang Ko, M.D.
• Kong Du (Lice Clinics of America - Castro Valley)
• Raymond L. Kong, PHARM D.
• Kathleen Jo Kretzmer, LCSW
• Michael B. Krinsky, M.D.
• Michael Krosin, MD
• Ted Krzywicki, D.D.S.
• Christine Kucher, M.A., CCC-SLP

• Physical Therapist in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.