Carole Gong

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

298711 Issued in CA

Practice address

719 Santa Monica Blvd
Santa Monica, CA 90401-2601

Phone

(310) 260-9039

NPI assigned

Aug 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Evolution Physical Therapy IncGroup PAC ID 0244336964, 72 clinicians

Practice addresses (Care Compare)

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.

• Evolution Physical Therapy, Inc

  • Physical Therapist
  • Culver City, CA
  • NPI 1174601116

  Orthopedic

  Medicare reassignment Care Compare group NPD
• Physical Therapyworks Inc.

  • Physical Therapist
  • Santa Monica, CA
  • NPI 1780653626

  Orthopedic

  Medicare reassignment NPD
• Next Phase Medical PC

  • General Practice Physician
  • Culver City, CA
  • NPI 1821961863
  NPD (past)

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1174134241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 VIA DEL REY",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012601",
            "telephone_number": "310-260-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONG",
        "first_name": "CAROLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "298711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Gomez, PHYSICIAN ASSISTANT
• Gloria Johanna Gomez, MA
• Jillienne Krystle Gomez
• Marc Aurelio Gomez, L.AC.
• Charles Gondell, MFT
• Wesley Gong, MD
• Danielle Gonzales, PSYD
• Allyson Ann Gonzalez, M.D.
• Araceli Gonzalez
• Carlos Alonso Gonzalez, PT, DPT

• Orthopedic Physical Therapist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.