Benjamin Kong

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

41074 Issued in CA

Practice address

301 Industrial Rd
San Carlos, CA 94070-2603

Phone

(650) 632-0816

NPI assigned

Mar 14, 2014

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 names 1

• Benjamin James Fong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Agile Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Palo Alto, CA
  • NPI 1659445443
  NPD
• Health on Wheels PC

  • Physical Therapist
  • San Mateo, CA
  • NPI 1326453606
  NPD (past)

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1104242080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-632-0816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 8th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941222407",
            "country_code": "US",
            "telephone_number": "415-794-7976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONG",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-14",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "41074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENJAMIN",
            "last_name": "FONG",
            "middle_name": "JAMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Andrew Klieves Sr.
• Crystal Necole Klingele
• R. B. Kniskern, PH.D., L.AC., O.M.D.
• Angelina Koesnodihardjo
• Nichole Kohake
• Cheryl Ann Koskinen, ACSW
• Kalina Kotseva, MSCA, OTR/L
• Kotzan Chiropractic
• Phillip David Kotzan, D.C.
• Pamela Beth Krasner, M.S.W.

• Physical Therapist in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.