Individual provider Active NPI

Pua Kapu, PHYSICAL THERAPY

  • Physical Therapist
  • Carlsbad, CA
National Provider Identifier
1215225644
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 19632 Issued in CA
Practice address
5050 Avenida Encinas
Suite # 250
Carlsbad, CA 92008-4381
Phone
(760) 729-5433
Fax
(619) 308-6004
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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 PT 19632 CA Primary

Addresses

Primary practice location

5050 Avenida Encinas
Suite # 250
Carlsbad, CA 92008-4381

Mailing address

5050 Avenida Encinas
Suite # 250
Carlsbad, CA 92008-4381
Phone (760) 729-5433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000673 CA Practitioner - Physical Therapist in Private Practice 4981877982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 19632CAMDPhysical Therapist
19632CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aqe Physical Therapy, Inc CurrentSince Feb 16, 2021 Accepting new patients
Active Life Rehab, Inc. Physical Therapist Past Accepting new patients

Locations

433 N 4th St
Ste 216
Montebello, CA 90640
Phone (323) 530-0433

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1215225644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 AVENIDA ENCINAS",
            "address_2": "SUITE # 250",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084381",
            "telephone_number": "760-729-5433",
            "fax_number": "619-308-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 AVENIDA ENCINAS",
            "address_2": "SUITE # 250",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084381",
            "telephone_number": "760-729-5433",
            "fax_number": "619-308-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPU",
        "first_name": "PUA",
        "credential": "PHYSICAL  THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 19632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.