Individual provider Active NPI

Joseph Ku

  • Orthopedic Physical Therapist
  • Glendale, CA
National Provider Identifier
1104245075
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
41070 Issued in CA
Practice address
500 W Glenoaks Blvd
Glendale, CA 91202-2813
Phone
(818) 637-2127
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 41070 CA Primary

Addresses

Primary practice location

500 W Glenoaks Blvd
Glendale, CA 91202-2813

Mailing address

500 W Glenoaks Blvd
Glendale, CA 91202-2813
Phone (818) 637-2127

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140520002326 CA Practitioner - Physical Therapist in Private Practice 7113140138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41070CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 1, 2014 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 1, 2014 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

8311 Florence Ave
Downey, CA 90240
Phone (310) 923-4911

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1104245075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022813",
            "telephone_number": "818-637-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W GLENOAKS BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022813",
            "telephone_number": "818-637-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KU",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "41070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1635 Divisadero St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941153036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.