Individual provider Active NPI

Shane Yap, DPT

  • Physical Therapist
  • West Hollywood, CA
National Provider Identifier
1164880464
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
292920 Issued in CA
Practice address
8354 Santa Monica Blvd
West Hollywood, CA 90069-4313
Phone
(323) 831-2455
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2994 NV
Physical Rehabilitation Occupational Therapist 225XP0019X 2994 NV
Physical Therapist 225100000X 292920 CA Primary

Addresses

Primary practice location

8354 Santa Monica Blvd
West Hollywood, CA 90069-4313

Mailing address

8354 Santa Monica Blvd
West Hollywood, CA 90069-4313
Phone (323) 831-2455

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180328002976 CA Practitioner - Physical Therapist in Private Practice 0547548877 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
292920CAMDPhysical Therapist
2994NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ishcorp Enterprises Physical Therapist CurrentSince Mar 13, 2017 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Jul 8, 2019 Accepting new patients
Myodetox California PC Inc. CurrentSince Apr 23, 2023 Accepting new patients
North Carolina Luna Care Physical Therapy LLC Physical Therapist PastSince Apr 6, 2021 Accepting new patients
Executive Fitness Inc PastSince Feb 1, 2016 Accepting new patients

Locations

7451 Warner Ave
Ste A
Huntington Beach, CA 92647
Phone (714) 593-0700

11611 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 447-6060

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

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

8354 Santa Monica Blvd
West Hollywood, CA 90069
Phone (323) 831-2455

Organizations & group practices 5

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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1164880464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8354 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694313",
            "telephone_number": "323-831-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8354 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694313",
            "telephone_number": "323-831-2455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAP",
        "first_name": "SHANE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2994",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NV",
            "license": "2994",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.