Individual provider Active NPI

Kaisa Chang

  • Physical Therapist
  • Elk Grove, CA
National Provider Identifier
1184401960
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
304754 Issued in CA
Practice address
9563 Laguna Springs Dr Ste 200
Elk Grove, CA 95758-8205
Phone
(916) 691-9822
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 304754 CA Primary

Addresses

Primary practice location

9563 Laguna Springs Dr Ste 200
Elk Grove, CA 95758-8205

Mailing address

9563 Laguna Springs Dr Ste 200
Elk Grove, CA 95758-8205
Phone (916) 691-9822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131001577 CA Practitioner - Physical Therapist in Private Practice 9537512157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stac Physical Therapy Laguna IncGroup PAC ID 7416384391, 5 clinicians

Practice addresses (Care Compare)

9563 Laguna Springs Dr
Elk Grove, CA 95758-8204
Phone (916) 691-9822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Laguna Physical Therapy & Hand Rehabilitation Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients

Locations

9563 Laguna Springs Dr
Elk Grove, CA 95758
Phone (916) 224-5918

9563 Laguna Springs Dr
Ste 200
Elk Grove, CA 95758
Phone (916) 691-9822

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": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1184401960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9563 LAGUNA SPRINGS DR STE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588205",
            "telephone_number": "916-691-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9563 LAGUNA SPRINGS DR STE 200",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588205",
            "telephone_number": "916-691-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KAISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.