Individual provider Active NPI

Michelle Khoshaba

  • Physical Therapist
  • El Segundo, CA
National Provider Identifier
1124993720
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
325 Main St
El Segundo, CA 90245-3814
Phone
(310) 648-3167
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 Primary

Addresses

Primary practice location

325 Main St
El Segundo, CA 90245-3814

Mailing address

2744 S Barrington Ave
Los Angeles, CA 90064-3611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021004243 CA Practitioner - Physical Therapist in Private Practice 7315435443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Davis and Derosa Physical Therapy IncGroup PAC ID 7113954264, 21 clinicians
Manhattan Beach Pacific Physical Therapy IncGroup PAC ID 4587619457, 11 clinicians

Practice addresses (Care Compare)

325 Main St
El Segundo, CA 90245-3814
Phone (310) 648-3167

327 Main St
El Segundo, CA 90245-3814
Phone (310) 725-8505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Davis and Derosa Physical Therapy, Inc Physical Therapist CurrentSince Oct 7, 2025 Accepting new patients
Manhattan Beach Pacific Physical Therapy Inc Physical Therapist CurrentSince Oct 7, 2025 Accepting new patients

Locations

325 Main St
El Segundo, CA 90245
Phone (310) 648-3167

327 Main St
El Segundo, CA 90245
Phone (310) 322-9700

2615 Pacific Coast Hwy
Ste 120
Hermosa Beach, CA 90254
Phone (310) 933-3690

2615 Pacific Coast Hwy
Ste 125
Hermosa Beach, CA 90254
Phone (310) 798-6310

Organizations & group practices 2

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": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1124993720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2744 S BARRINGTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 MAIN ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453814",
            "telephone_number": "310-648-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHABA",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.