Individual provider Active NPI

Jaeho Choi, DPT

  • Physical Therapist
  • Buena Park, CA
National Provider Identifier
1114650702
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT302015 Issued in CA
Practice address
5832 Beach Blvd Ste 114
Buena Park, CA 90621-2010
Phone
(714) 707-2699
Fax
(714) 784-2160
NPI assigned
Jul 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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 PT302015 CA Primary

Addresses

Primary practice location

5832 Beach Blvd Ste 114
Buena Park, CA 90621-2010

Mailing address

12465 Lewis St Ste 101
Garden Grove, CA 92840-4658
Phone (714) 703-8477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926002203 CA Practitioner - Physical Therapist in Private Practice 8426434655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower Physical Therapy and Wellness, IncGroup PAC ID 6002112018, 9 clinicians

Practice addresses (Care Compare)

5632 Philadelphia St
Suite 102
Chino, CA 91710-2411
Phone (909) 925-0015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT302015CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Physical Therapy, Inc Physical Therapist CurrentSince May 31, 2022 Accepting new patients
Innovative Management Inc CurrentSince Jul 17, 2022 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Apr 8, 2024 Accepting new patients
Empower Physical Therapy and Wellness, Inc Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients

Locations

5632 Philadelphia St
Ste 102
Chino, CA 91710
Phone (909) 925-0015

15944 Los Serranos Country Club Dr
Ste 250
Chino Hills, CA 91709
Phone (909) 907-0805

12465 Lewis St
Ste 101
Garden Grove, CA 92840
Phone (714) 703-8477

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1114650702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12465 LEWIS ST STE 101",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404658",
            "telephone_number": "714-703-8477",
            "fax_number": "714-703-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BEACH BLVD STE 114",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212010",
            "telephone_number": "714-707-2699",
            "fax_number": "714-784-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JAEHO",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-01",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT302015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.